How To Use CPT Code 25660

CPT code 25660 describes the closed treatment of radiocarpal or intercarpal dislocation, involving one or more bones, with 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 25660?

CPT 25660 is used to describe the closed treatment of a dislocation injury in the wrist involving one or more bones. This procedure is performed without making an incision and involves manipulating the bones back into their correct positions. Radiocarpal dislocations are rare and usually occur as a result of a significant impact injury.

2. Official Description

The official description of CPT code 25660 is: ‘Closed treatment of radiocarpal or intercarpal dislocation, one or more bones, with manipulation.’

3. Procedure

1. The provider assesses the patient’s wrist using radiographic imaging to determine the presence of a dislocation of one or more carpal bones or the distal radius.
2. The provider uses their hands to manipulate the bones and return them to their correct positions.
3. Another radiographic image is obtained to confirm that the bones have been adequately realigned.
4. A splint or cast material is applied to immobilize the bones and promote healing.

4. Qualifying circumstances

CPT 25660 is used for patients who have a dislocation of one or more carpal bones or the distal radius in association with a carpal bone. The procedure must be performed by a qualified healthcare professional and involve manipulation without making an incision.

5. When to use CPT code 25660

CPT code 25660 should be used when a provider performs closed treatment of a radiocarpal or intercarpal dislocation, involving one or more bones, with manipulation. It should not be used if an incision is made or if a different treatment method is used.

6. Documentation requirements

To support a claim for CPT 25660, the provider must document the following information:

• Diagnosis of the dislocation and the need for closed treatment
• Details of the manipulation procedure, including the specific bones involved
• Date of the procedure
• Confirmation of adequate realignment through radiographic imaging
• Type of immobilization applied (splint or cast)

7. Billing guidelines

When billing for CPT 25660, ensure that the procedure meets the criteria for closed treatment of a radiocarpal or intercarpal dislocation, involving one or more bones, with manipulation. It should not be reported if an incision is made or if a different treatment method is used. Consider reporting additional supplies of casting materials using a separate code, such as 99070.

8. Historical information

CPT 25660 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on January 1, 2010 to its current description.

9. Examples

1. A patient presents with a dislocated scaphoid bone in their wrist. The provider performs closed treatment with manipulation to realign the bone and applies a cast for immobilization.
2. A patient sustains a dislocation of the lunate bone in their wrist. The provider manipulates the bone back into its correct position and applies a splint for immobilization.
3. A patient presents with a dislocated triquetrum bone in their wrist. The provider performs closed treatment with manipulation to realign the bone and applies a cast for immobilization.
4. A patient sustains a dislocation of the pisiform bone in their wrist. The provider manipulates the bone back into its correct position and applies a splint for immobilization.
5. A patient presents with a dislocated trapezium bone in their wrist. The provider performs closed treatment with manipulation to realign the bone and applies a cast for immobilization.
6. A patient sustains a dislocation of the trapezoid bone in their wrist. The provider manipulates the bone back into its correct position and applies a splint for immobilization.
7. A patient presents with a dislocated capitate bone in their wrist. The provider performs closed treatment with manipulation to realign the bone and applies a cast for immobilization.
8. A patient sustains a dislocation of the hamate bone in their wrist. The provider manipulates the bone back into its correct position and applies a splint for immobilization.
9. A patient presents with a dislocated scaphoid and lunate bone in their wrist. The provider performs closed treatment with manipulation to realign the bones and applies a cast for immobilization.
10. A patient sustains a dislocation of the triquetrum and pisiform bone in their wrist. The provider manipulates the bones back into their correct positions and applies a splint for immobilization.