2025 CPT code 25574

Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius or ulna.

Consult the most current CPT guidelines for detailed coding instructions.Specific attention should be paid to guidelines related to open vs. closed treatment, internal vs. external fixation, and the use of modifiers.

Modifiers may be applicable depending on the circumstances of the procedure.For example, modifier 54 (Surgical care only) may be appended if the performing physician is not providing post-operative care.Modifiers 76 (Repeat procedure by the same physician) or 77 (Repeat procedure by another physician) might be used if the procedure is repeated.Consult the most current CPT guidelines for modifier usage.

Medical necessity for open reduction internal fixation is typically established by the severity and displacement of the fracture(s), inability to achieve satisfactory alignment with closed reduction, and the need for stabilization to prevent malunion or nonunion.Documentation should support the need for surgical intervention over alternative treatments.Specific payer requirements and guidelines should be consulted.

The orthopedic surgeon is responsible for pre-operative planning, performing the open reduction and internal fixation surgery, post-operative care, and follow-up.This may involve obtaining informed consent, preparing the patient, making the incision, reducing the fracture, inserting implants, ensuring hemostasis, closing the incision, applying a cast or splint, providing post-operative instructions, and monitoring the patient’s progress.

IMPORTANT If external fixation is used in addition to internal fixation, report 20690 and the appropriate internal fixation code.If the cast is removed by someone other than the physician who applied it, report a cast removal code (29700, 29705, 29710). Subsequent replacement of cast, splint, or traction device during or after the global period may be reported separately.

In simple words: This code covers surgery to fix broken bones in the forearm. The doctor makes a cut to realign the broken bones and may use metal plates, screws, or wires to hold them in place.A cast or splint is used to keep the bones still until they heal.

This CPT code, 25574, describes the open surgical treatment of fractures in the shafts of the radius and/or ulna bones of the forearm.The procedure involves an incision to access the fracture site(s), reduction (realignment) of the fractured bone(s), and internal fixation (using plates, screws, or wires) to stabilize the fracture(s) and promote healing.Internal fixation is only performed when necessary; one bone may be adequately aligned without it. The procedure includes irrigation, hemostasis (control of bleeding), and closure of the incision.A cast or splint is applied post-operatively for immobilization.

Example 1: A 25-year-old male sustains a high-energy both-bone forearm fracture in a motorcycle accident.Open reduction and internal fixation with plating is performed on both the radius and ulna., A 60-year-old female falls and fractures her radius and ulna. Open reduction is performed on the radius with internal fixation using a plate and screws. The ulna fracture is managed with closed reduction and casting., A 15-year-old male sustains a comminuted (fragmented) fracture of the radius and ulna in a sports injury. Open reduction and internal fixation with a bridge plate is utilized for the radius, while the ulna is stabilized with a plate and screws.

** Accurate coding requires careful documentation of the surgical procedure performed, including the specific bones treated, the type of internal fixation used, and whether both bones required surgical intervention or if one fracture was managed without internal fixation.The use of imaging to confirm reduction is also important to document.Always consult the most up-to-date CPT coding guidelines and payer-specific policies for accurate billing.

  • Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
  • RVU: This information is not available in the provided text.Consult the most up-to-date Relative Value Units (RVUs) database for current values.
  • Global Days : The global period for this procedure is not specified in the provided text. Consult the most recent CPT guidelines for details on the global period.
  • Payment Status: Active
  • Modifier TC rule: A technical component (TC) modifier is not applicable to this code.
  • Fee Schedule : This information is not available in the provided text.Consult the most recent fee schedules and payment databases for reimbursement information.
  • Specialties:Orthopedic Surgery
  • Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Office
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