How To Use CPT Code 25695

CPT 25695 describes the open treatment of lunate dislocation, a procedure used to repair a fracture of the bones in the wrist. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 25695?

CPT 25695 is used to describe the open treatment of lunate dislocation, a procedure that involves repairing a fracture in the bones of the wrist through a skin incision. This type of fracture is typically the result of major trauma to other bones in the wrist and hand.

2. Official Description

The official description of CPT code 25695 is: ‘Open treatment of lunate dislocation.’

3. Procedure

1. The provider manipulates the fracture into the correct position using radiographic imaging.
2. An incision is made in the skin proximal or distal to the fracture site.
3. A nail is threaded down into the intramedullary canal, through the bone, and across the fracture site to stabilize the fracture.
4. Interlocking screws may be placed at angles to the nail to further stabilize the fracture.

4. Qualifying circumstances

CPT 25695 is used for patients who have a lunate dislocation, which is a specific type of fracture in the bones of the wrist. This procedure is typically performed when the fracture is the result of major trauma to other bones in the wrist and hand.

5. When to use CPT code 25695

CPT code 25695 should be used when the provider performs an open treatment for lunate dislocation. It is important to ensure that the procedure performed matches the description of the code. If the procedure performed does not match the description, a different code should be used.

6. Documentation requirements

To support a claim for CPT 25695, the provider must document the following information:

• Description of the lunate dislocation and the need for open treatment
• Details of the procedure performed, including the approach used and any additional stabilization methods
• Date of the procedure
• Any complications or unexpected findings during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 25695, ensure that the procedure performed matches the description of the code. It is important to follow the specific guidelines provided by the payer to ensure accurate and appropriate billing. If there are any additional procedures or services performed during the same encounter, they should be reported separately using the appropriate codes.

8. Historical information

CPT 25695 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 patient sustains a lunate dislocation due to a fall and undergoes open treatment of the fracture to realign the bones and stabilize the fracture.
2. After a car accident, a patient presents with a lunate dislocation and undergoes open treatment to repair the fracture and restore proper alignment.
3. A professional athlete fractures their wrist during a game and requires open treatment of the lunate dislocation to ensure proper healing and return to play.
4. A patient with a history of osteoporosis experiences a lunate dislocation and undergoes open treatment to stabilize the fracture and prevent further complications.
5. Following a workplace accident, a patient presents with a lunate dislocation and undergoes open treatment to repair the fracture and restore function to the wrist.
6. A patient involved in a motorcycle accident sustains a lunate dislocation and requires open treatment to realign the bones and promote proper healing.
7. An elderly patient falls and fractures their wrist, resulting in a lunate dislocation that requires open treatment to restore function and reduce pain.
8. A patient with a history of rheumatoid arthritis develops a lunate dislocation and undergoes open treatment to stabilize the fracture and improve joint function.
9. After a sports-related injury, a patient presents with a lunate dislocation and undergoes open treatment to repair the fracture and allow for proper healing.
10. A patient involved in a car crash sustains a lunate dislocation and requires open treatment to realign the bones and restore function to the wrist.