How To Use CPT Code 25535

CPT 25535 describes the closed treatment of an ulnar shaft fracture with manipulation. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 25535?

CPT 25535 is used to describe the closed treatment of an ulnar shaft fracture with manipulation. This procedure involves the provider manipulating the fracture into alignment without making an incision.

2. Official Description

The official description of CPT code 25535 is: ‘Closed treatment of ulnar shaft fracture; with manipulation.’

3. Procedure

1. The provider begins by assessing the patient’s condition and confirming the presence of an ulnar shaft fracture through radiographic imaging.
2. Once the fracture is identified, the provider uses their hands to manipulate the fractured bones into their correct positions.
3. After manipulation, the provider obtains another radiographic image to ensure that the fracture is adequately reduced.
4. To prevent movement of the fracture during the healing process, the provider applies a splint or cast material.

4. Qualifying circumstances

CPT 25535 is appropriate for patients who have a fracture of the ulnar shaft that requires closed treatment with manipulation. The procedure must be performed without making an incision.

5. When to use CPT code 25535

CPT code 25535 should be used when a provider performs closed treatment of an ulnar shaft fracture with manipulation. It is important to note that this code should not be used if the treatment involves an open procedure or if an incision is made.

6. Documentation requirements

To support a claim for CPT 25535, the provider must document the following information:

• Confirmation of the ulnar shaft fracture through radiographic imaging
• Description of the manipulation technique used
• Documentation of the application of a splint or cast material

7. Billing guidelines

When billing for CPT 25535, ensure that the procedure meets the criteria for closed treatment of an ulnar shaft fracture with manipulation. It is important to accurately document the procedure and any additional supplies used. Modifier 54, Surgical care only, may be necessary if the provider will not see the patient for follow-up care. Additionally, consider reporting separate evaluation and management (E/M) services if applicable.

8. Historical information

CPT 25535 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider performs closed treatment with manipulation for an ulnar shaft fracture in a patient who fell from a bicycle.
2. A patient presents with an ulnar shaft fracture due to a sports injury, and the provider manipulates the fracture into alignment without making an incision.
3. A provider treats an ulnar shaft fracture in a patient involved in a car accident by performing closed treatment with manipulation.
4. A patient sustains an ulnar shaft fracture from a fall, and the provider performs closed treatment with manipulation to realign the fractured bones.
5. A provider treats an ulnar shaft fracture in a patient who was injured during a workplace accident by performing closed treatment with manipulation.
6. A patient presents with an ulnar shaft fracture resulting from a recreational activity, and the provider performs closed treatment with manipulation to restore normal anatomy.
7. A provider treats an ulnar shaft fracture in a patient involved in a sports-related incident by performing closed treatment with manipulation.
8. A patient sustains an ulnar shaft fracture from a fall down the stairs, and the provider performs closed treatment with manipulation to ensure proper alignment.
9. A provider treats an ulnar shaft fracture in a patient who was injured while playing a musical instrument by performing closed treatment with manipulation.
10. A patient presents with an ulnar shaft fracture resulting from a physical altercation, and the provider performs closed treatment with manipulation to facilitate healing.