How To Use CPT Code 25565

CPT 25565 describes the closed treatment of radial and ulnar shaft fractures 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 25565?

CPT 25565 can be used to describe the closed treatment of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna, with manipulation. This code is used when the provider manipulates the fractures into alignment without making an incision.

2. Official Description

The official description of CPT code 25565 is: ‘Closed treatment of radial and ulnar shaft fractures; with manipulation.’

3. Procedure

1. The provider begins by assessing the patient’s forearm fracture using radiographic imaging.
2. Once the presence of a both bone fracture is confirmed, the provider uses their hands to manipulate the fractured bones into their correct positions.
3. Another radiographic image is obtained to ensure that the fracture has been adequately reduced.
4. To prevent movement of the fracture during the healing process, the provider applies a splint or cast material.

4. Qualifying circumstances

Patients eligible to receive CPT 25565 services are those with both bone fractures in the forearm, specifically involving the shafts of the radius and ulna. The treatment must be performed in a closed procedure, meaning no surgical incision is made. The provider must also manipulate the fractures into alignment.

5. When to use CPT code 25565

CPT code 25565 should be used when a provider performs closed treatment of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna, with manipulation. This code should not be used if an incision is made or if manipulation is not performed.

6. Documentation requirements

To support a claim for CPT 25565, the provider must document the following information:

• Confirmation of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna
• Description of the manipulation technique used
• Date of the procedure
• Confirmation of adequate reduction of the fracture through radiographic imaging
• Type of splint or cast material applied

7. Billing guidelines

When billing for CPT 25565, ensure that the treatment is performed in a closed procedure without making an incision. The manipulation of the fractures must also be documented. It is important to note that additional supplies of casting materials may need to be reported separately using appropriate HCPCS codes.

8. Historical information

CPT 25565 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 a both bone fracture in the forearm of a patient involved in a car accident.
2. A patient presents with a both bone fracture in the forearm after a fall, and the provider performs closed treatment with manipulation to realign the fractured bones.
3. A child sustains a both bone fracture in the forearm while playing sports, and the provider performs closed treatment with manipulation to correct the alignment of the fractured bones.
4. A provider treats a both bone fracture in the forearm of an elderly patient who fell at home, using closed treatment with manipulation to restore the normal anatomy.
5. A patient presents with a both bone fracture in the forearm after a workplace accident, and the provider performs closed treatment with manipulation to ensure proper alignment of the fractured bones.
6. A provider treats a both bone fracture in the forearm of a patient involved in a sports injury, using closed treatment with manipulation to achieve adequate reduction of the fracture.
7. A child sustains a both bone fracture in the forearm while playing on the playground, and the provider performs closed treatment with manipulation to realign the fractured bones.
8. A patient presents with a both bone fracture in the forearm after a fall from a ladder, and the provider performs closed treatment with manipulation to restore the normal anatomy.
9. A provider treats a both bone fracture in the forearm of an elderly patient who slipped on ice, using closed treatment with manipulation to ensure proper alignment of the fractured bones.
10. A patient presents with a both bone fracture in the forearm after a sports-related injury, and the provider performs closed treatment with manipulation to achieve adequate reduction of the fracture.