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2025 CPT code 24640

Closed treatment of radial head subluxation (nursemaid's elbow) in a child, with manipulation.

This code is specific to radial head subluxation in children. It includes the application of the first cast, splint, or traction device, if necessary. Modifier 25 may be appended to an E/M code billed on the same day if a significant, separately identifiable E/M service was provided.

Modifiers may apply. Common modifiers include 25 (significant, separately identifiable E/M service), 54 (surgical care only), 76 (repeat procedure by same physician), or 77 (repeat procedure by another physician).

Medical necessity for this procedure is established by the presence of a radial head subluxation causing pain and limited range of motion in the affected elbow.

The physician examines the child's elbow, diagnoses the radial head subluxation, and performs the manipulation to reduce the dislocation. This may involve hyperpronation or supination-flexion techniques. The physician may also recommend temporary immobilization or pain management strategies.

In simple words: The doctor fixes a child's partially dislocated elbow (nursemaid's elbow) by moving the bones back into place without surgery.

This code describes the closed treatment of a partially dislocated radial head at the elbow joint in a child (commonly known as nursemaid's elbow). The procedure involves manipulating the elbow back into its proper position without surgical intervention.

Example 1: A 2-year-old child is brought to the clinic after their parent pulled on their arm, causing a nursemaid's elbow. The physician diagnoses radial head subluxation and performs a closed reduction., A 3-year-old falls and lands awkwardly on their outstretched arm, resulting in a nursemaid's elbow. The physician confirms the diagnosis and manipulates the elbow back into place., A 4-year-old child presents with limited elbow mobility and pain after swinging from monkey bars. The physician identifies a radial head subluxation and performs a closed reduction.

Documentation should include details of the injury, physical examination findings confirming the diagnosis of radial head subluxation, the method of reduction used, and any post-reduction care provided (e.g., sling, pain management advice).

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