How To Use CPT Code 25574

CPT 25574 describes the open treatment of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna. 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 25574?

CPT 25574 is used to describe the open treatment of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna. In this procedure, the provider makes an incision to realign one of the bones and may apply hardware, such as plates, screws, nails, or wires, to stabilize it. The other bone does not require realignment or hardware.

2. Official Description

The official description of CPT code 25574 is: ‘Open treatment of radial AND ulnar shaft fractures, with internal fixation, when performed; of radius OR ulna.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision over the area of the both bone fracture.
3. One of the bones is reduced and a plate and screws or wires may be applied, if necessary.
4. The provider confirms the reduction using imaging.
5. The area is irrigated, checked for bleeding, and any instruments are removed.
6. The incision is closed and a splint or cast material is applied to prevent movement of the fracture.

4. Qualifying circumstances

Patients eligible for CPT 25574 are those with both bone fractures in the forearm, specifically involving the shafts of the radius and ulna. The procedure involves open treatment, which refers to a surgical incision, and may include internal fixation with hardware. The provider determines the need for realignment and applies hardware, if necessary, to stabilize the fracture.

5. When to use CPT code 25574

CPT code 25574 should be used when the provider performs open treatment of both bone fractures in the forearm, involving the shafts of the radius and ulna. This code is appropriate when the provider makes an incision, realigns one of the bones, and may apply hardware to stabilize the fracture. If the procedure does not involve both bone fractures or does not require open treatment with internal fixation, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 25574, the provider must document the following information:

• Patient’s diagnosis of both bone fractures in the forearm
• Details of the procedure, including the incision, reduction, and application of hardware, if necessary
• Confirmation of the reduction using imaging
• Documentation of irrigation, bleeding control, instrument removal, and closure of the incision
• Application of a splint or cast material to prevent movement of the fracture

7. Billing guidelines

When billing for CPT 25574, ensure that the procedure involves open treatment of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna. Use the appropriate CPT code based on the specific details of the procedure performed. It is important to accurately document the procedure and provide any necessary supporting documentation for proper billing and reimbursement.

8. Historical information

CPT 25574 was added to the Current Procedural Terminology system on January 1, 1993. On January 1, 2008, there was a code change that expanded the description to include internal or external fixation.

9. Examples

1. A surgeon performing open treatment of both bone fractures in the forearm, involving the shafts of the radius and ulna, by making an incision, realigning one of the bones, and applying hardware to stabilize the fracture.
2. An orthopedic specialist performing open treatment of both bone fractures in the forearm, involving the shafts of the radius and ulna, by making an incision, reducing one of the bones, and confirming the reduction using imaging.
3. A trauma surgeon performing open treatment of both bone fractures in the forearm, involving the shafts of the radius and ulna, by making an incision, applying a plate and screws to stabilize the fracture, and closing the incision.
4. An orthopedic surgeon performing open treatment of both bone fractures in the forearm, involving the shafts of the radius and ulna, by making an incision, reducing one of the bones, and applying wires to stabilize the fracture.
5. A hand surgeon performing open treatment of both bone fractures in the forearm, involving the shafts of the radius and ulna, by making an incision, reducing one of the bones, and applying a combination of plates and screws to stabilize the fracture.
6. An orthopedic specialist performing open treatment of both bone fractures in the forearm, involving the shafts of the radius and ulna, by making an incision, reducing one of the bones, and applying an external fixator to stabilize the fracture.
7. A trauma surgeon performing open treatment of both bone fractures in the forearm, involving the shafts of the radius and ulna, by making an incision, reducing one of the bones, and applying an intramedullary nail to stabilize the fracture.
8. An orthopedic surgeon performing open treatment of both bone fractures in the forearm, involving the shafts of the radius and ulna, by making an incision, reducing one of the bones, and applying a combination of plates, screws, and wires to stabilize the fracture.