How To Use CPT Code 25575

CPT 25575 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 25575?

CPT 25575 is used to describe the open treatment of fractures in both bones of the forearm, specifically the radius and ulna. This code is used when a provider performs an incision to realign the fractured bones and may use hardware, such as plates and screws, to stabilize the fractures.

2. Official Description

The official description of CPT code 25575 is: ‘Open treatment of radial AND ulnar shaft fractures, with internal fixation, when performed; of radius AND 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. The provider reduces each of the fractures and applies a plate and screws or wires, as necessary.
4. Imaging is used to confirm the reduction.
5. The provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision.
6. A splint or cast material is applied to prevent movement of the fracture until healing takes place.

4. Qualifying circumstances

Patients eligible for CPT 25575 are those with both bone fractures in the forearm, specifically involving the shafts of the radius and ulna. The procedure must involve open treatment, which refers to a surgical incision, and may include internal fixation using hardware.

5. When to use CPT code 25575

CPT code 25575 should be used when a provider performs open treatment of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna. This code should not be used for closed treatment or fractures in other areas of the forearm or wrist.

6. Documentation requirements

To support a claim for CPT 25575, the provider must document the following information:

• Specific details of the both bone fractures in the forearm
• Description of the open treatment procedure performed
• Use of any hardware, such as plates and screws
• Confirmation of reduction through imaging
• Details of the closure and application of a splint or cast material

7. Billing guidelines

When billing for CPT 25575, ensure that the procedure involves open treatment of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna. Use additional codes if necessary to report any other procedures or services performed during the same encounter. Follow any specific guidelines provided by payers for proper billing and reimbursement.

8. Historical information

CPT 25575 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including a code change on January 1, 2008, which expanded the description to include internal or external fixation.

9. Examples

1. A surgeon performs an open treatment of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna, using internal fixation with plates and screws.
2. A provider performs an open reduction of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna, and applies an external fixator for stabilization.
3. A patient undergoes open treatment of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna, with internal fixation using wires.
4. A surgeon performs an open reduction and internal fixation of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna, using a combination of plates, screws, and wires.
5. A provider performs an open treatment of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna, with external fixation using pins and an external frame.
6. A patient undergoes open reduction and internal fixation of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna, using a combination of plates and screws.
7. A surgeon performs an open treatment of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna, with external fixation using pins and a circular frame.
8. A provider performs an open reduction and internal fixation of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna, using plates and screws.
9. A patient undergoes open treatment of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna, with external fixation using pins and a unilateral frame.
10. A surgeon performs an open reduction and internal fixation of both bone fractures in the forearm, specifically involving the shafts of the radius and ulna, using a combination of plates, screws, and wires.