How To Use CPT Code 25635

CPT 25635 describes the closed treatment of a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone, using manipulation only. 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 25635?

CPT 25635 can be used to describe the closed treatment of a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone, using manipulation only. This code is used when a healthcare provider manipulates the bones in the wrist to realign them into their correct positions without making a surgical incision.

2. Official Description

The official description of CPT code 25635 is: ‘Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); with manipulation, each bone.’

3. Procedure

1. The healthcare provider uses radiographic imaging to determine the presence of a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone.
2. The provider then manipulates the bones in the wrist using their hands or instruments to realign them into their correct positions.
3. Another radiographic image is obtained to confirm that the fracture has been adequately reduced.
4. A splint or cast material is applied to prevent movement of the fracture and promote healing.

4. Qualifying circumstances

Patients eligible to receive CPT 25635 services are those with a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone. The treatment must be performed using manipulation only, without making a surgical incision.

5. When to use CPT code 25635

CPT code 25635 should be used when a healthcare provider performs closed treatment of a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone, using manipulation only. This code should be reported for each carpal bone treated.

6. Documentation requirements

To support a claim for CPT 25635, the healthcare provider must document the following information:

• Presence of a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone
• Use of manipulation to realign the bones into their correct positions
• Confirmation of adequate reduction of the fracture through radiographic imaging
• Application of a splint or cast material to prevent movement of the fracture

7. Billing guidelines

When billing for CPT 25635, ensure that the treatment is performed using manipulation only, without making a surgical incision. Report CPT 25635 for each carpal bone treated. Consider if restorative treatments or procedures will be performed and if there are risks associated with the fracture when deciding whether to report the service as a global code or itemized. Additional supplies of casting materials may be reported separately using CPT code 99070.

8. Historical information

CPT 25635 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on January 1, 2009 to its current description.

9. Examples

1. A healthcare provider performs closed treatment with manipulation of a fracture in the triquetrum bone in the wrist.
2. A patient presents with a fracture in the capitate bone in the wrist, and a healthcare provider performs closed treatment using manipulation only.
3. A healthcare provider treats a fracture in the hamate bone in the wrist with closed treatment and manipulation.
4. A patient sustains a fracture in the trapezium bone in the wrist, and a healthcare provider performs closed treatment using manipulation.
5. A healthcare provider manipulates the bones in the wrist to treat a fracture in the trapezoid bone using closed treatment with manipulation.
6. A patient fractures the pisiform bone in the wrist, and a healthcare provider performs closed treatment using manipulation only.
7. A healthcare provider treats a fracture in the lunate bone in the wrist with closed treatment and manipulation.
8. A patient presents with a fracture in the triquetrum bone in the wrist, and a healthcare provider performs closed treatment using manipulation only.
9. A healthcare provider manipulates the bones in the wrist to treat a fracture in the capitate bone using closed treatment with manipulation.
10. A patient sustains a fracture in the hamate bone in the wrist, and a healthcare provider performs closed treatment using manipulation.