2025 CPT code 25420

Repair of nonunion or malunion of both the radius and ulna bones in the forearm, using a bone graft from the patient's own body.

The application and removal of the first cast, splint, or traction device are included in the code. Subsequent replacements can be billed separately. Modifier 54 is used if the initial treating physician does not perform subsequent care.

Modifiers such as 22 (increased procedural services), 50 (bilateral procedure), 51 (multiple procedures), 52 (reduced services), 59 (distinct procedural service), 62 (two surgeons), 76 (repeat procedure by same physician), and others may be applicable.

Medical necessity for this procedure is established by documenting the functional impairment caused by the nonunion or malunion, such as limited range of motion, pain, or instability.

The physician is responsible for the entire surgical procedure, including incision, bone repair, obtaining the graft, and closure.

In simple words: This surgery fixes a broken forearm when the radius and ulna bones haven't healed properly or have healed in the wrong position. The surgeon takes a piece of bone from another part of your body and uses it to help the forearm bones heal correctly.

This procedure addresses nonunion (failure of a fractured bone to heal) or malunion (healing of a fractured bone in an incorrect position) of both the radius and ulna bones in the forearm. It involves surgically exposing the affected bones, removing the improperly healed or unhealed bone tissue, and then grafting bone from elsewhere in the patient's body (often the iliac crest) to bridge the gap and promote proper healing. The procedure includes obtaining the autograft.

Example 1: A patient has a nonunion of both the radius and ulna following a forearm fracture. Code 25420 is used for the repair with autograft., A patient has a malunion of the radius and ulna, resulting in limited forearm rotation. Code 25420 is used for the corrective surgery with autograft., A patient with a congenital deformity affecting both the radius and ulna undergoes corrective surgery. Bone grafting is performed, and 25420 is reported.

Documentation should include details of the fracture, evidence of nonunion or malunion (e.g., imaging studies), the source of the autograft, and the method of fixation.

  • Revenue Code: P3D
  • Specialties:Orthopedic Surgery, Hand Surgery
  • Place of Service:Ambulatory Surgical Center, Hospital - Inpatient, Hospital - Outpatient
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