How To Use CPT Code 25645

CPT 25645 describes the open treatment of a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone. 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 25645?

CPT 25645 can be used to describe the open treatment of a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone. This code is used when a provider makes an incision in the wrist to access the fracture and may apply wires or screws to secure the bones while healing takes place.

2. Official Description

The official description of CPT code 25645 is: ‘Open treatment of carpal bone fracture (other than carpal scaphoid [navicular]), each bone.’

3. Procedure

1. The provider makes an incision over the fracture site in the wrist.
2. The provider reduces, or realigns, the fracture into the correct position.
3. A radiographic image is obtained to confirm adequate reduction of the fracture.
4. The incision is closed.
5. A splint or cast material is applied to prevent movement of the fracture until healing takes place.

4. Qualifying circumstances

Patients eligible to receive CPT 25645 services are those with a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone. The provider must perform an open treatment of the fracture, which involves making an incision and may include the use of wires or screws to stabilize the bones. The scaphoid bone is not included in this code.

5. When to use CPT code 25645

It is appropriate to bill the 25645 CPT code when a provider performs an open treatment of a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone. This code should be used for each carpal bone treated.

6. Documentation requirements

To support a claim for CPT 25645, the provider must document the following information:

• Diagnosis of the fracture in one of the carpal bones in the wrist, excluding the scaphoid bone
• Details of the open treatment procedure, including the incision and any fixation methods used
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures or treatments performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 25645, ensure that the provider performs an open treatment of a fracture in one of the carpal bones in the wrist, excluding the scaphoid bone. This code should be reported for each carpal bone treated. Consider the global reporting option for fracture care, which includes the initial cast application and all professional services for a 90-day period. Additional supplies and services may be reported separately.

8. Historical information

CPT 25645 was added to the Current Procedural Terminology system on January 1, 1990. There have been two code changes since its addition, with the most recent change occurring on January 1, 2009.

9. Examples

1. A provider performing an open treatment of a fracture in the lunate bone of the wrist.
2. A provider performing an open treatment of a fracture in the triquetrum bone of the wrist.
3. A provider performing an open treatment of a fracture in the pisiform bone of the wrist.
4. A provider performing an open treatment of a fracture in the trapezium bone of the wrist.
5. A provider performing an open treatment of a fracture in the trapezoid bone of the wrist.
6. A provider performing an open treatment of a fracture in the capitate bone of the wrist.
7. A provider performing an open treatment of a fracture in the hamate bone of the wrist.