How To Use CPT Code 25630

CPT 25630 describes the closed treatment of a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone, without 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 25630?

CPT 25630 can be used to describe the closed treatment of a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone, without manipulation. This code is used when a provider treats a fracture in one of the carpal bones in the wrist using a closed procedure, without making an incision or using manipulation.

2. Official Description

The official description of CPT code 25630 is: ‘Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); without manipulation, each bone.’

3. Procedure

1. The provider assesses the presence of a fracture in one of the carpal bones in the wrist using radiographic imaging.
2. If a fracture is confirmed, the provider applies local treatment, such as ice and medication, to reduce pain and inflammation.
3. A splint or cast material is then applied to prevent movement of the fracture and promote healing.

4. Qualifying circumstances

Patients eligible to receive CPT 25630 services are those with a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone. The treatment must be performed without manipulation, and the provider must use a closed procedure, without making an incision.

5. When to use CPT code 25630

CPT code 25630 should be used when a provider performs a closed treatment of a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone, without manipulation. This code should be used for each bone treated.

6. Documentation requirements

To support a claim for CPT 25630, the provider must document the following information:

• Presence of a fracture in one of the carpal bones in the wrist
• Use of a closed procedure without manipulation
• Date of the treatment
• Specific carpal bone treated
• Type of splint or cast material applied

7. Billing guidelines

When billing for CPT 25630, ensure that the treatment is performed without manipulation and that it is a closed procedure. Report CPT 25630 for each carpal bone treated. Consider reporting additional supplies of casting materials using CPT code 99070.

8. Historical information

CPT 25630 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 applies a splint to treat a fracture in the lunate bone of a patient’s wrist.
2. A patient presents with a fracture in the triquetrum bone of their wrist, and the provider applies a cast for treatment.
3. A provider treats a fracture in the pisiform bone of a patient’s wrist using a closed procedure without manipulation.
4. A patient sustains a fracture in the trapezium bone of their wrist, and the provider applies a splint for treatment.
5. A provider applies a cast to treat a fracture in the trapezoid bone of a patient’s wrist.
6. A patient presents with a fracture in the capitate bone of their wrist, and the provider applies a splint for treatment.
7. A provider treats a fracture in the hamate bone of a patient’s wrist using a closed procedure without manipulation.
8. A patient sustains a fracture in multiple carpal bones of their wrist, and the provider applies a cast for treatment.
9. A provider applies a splint to treat a fracture in the capitate and hamate bones of a patient’s wrist.
10. A patient presents with a fracture in the triquetrum and pisiform bones of their wrist, and the provider applies a cast for treatment.