2025 CPT code 25575

Open treatment of radial and ulnar shaft fractures with internal fixation.

Follow CPT guidelines for fracture treatment, including appropriate modifier use (e.g., 54 for surgical care only, 76 for repeat procedure).Additional codes for casting materials, or other services can be added if applicable.

Modifiers 54 (Surgical Care Only), 76 (Repeat Procedure) may be applicable depending on the circumstances of the case.Other modifiers may apply based on specific situations.

Medical necessity is established by the presence of a displaced both-bone forearm fracture causing pain, instability, and impairment of function.ORIF is deemed medically necessary to restore anatomical alignment, provide stability, and promote healing. The specific type of internal fixation is chosen based on the fracture pattern and patient factors.

The physician's responsibilities include pre-operative preparation, surgical incision, fracture reduction, internal fixation, wound closure, and post-operative care instructions.

In simple words: The doctor performs surgery to fix broken bones in the forearm.This involves making an incision, realigning the broken bones, and using plates, screws, or wires to hold them in place.A cast or splint is then applied.

This CPT code, 25575, describes the open treatment of fractures in both the radius and ulna bones of the forearm, involving internal fixation.The procedure includes surgical incision, fracture reduction (realignment), and stabilization using internal fixation devices such as plates, screws, or wires.Imaging is used to confirm proper alignment. The incision is then closed, and a splint or cast is applied for immobilization.

Example 1: A patient presents with a displaced both-bone forearm fracture after a fall. The surgeon performs an open reduction and internal fixation (ORIF) using plates and screws, documented by intraoperative imaging. A cast is applied post-operatively., A patient sustains a high-energy both-bone forearm fracture in a motor vehicle accident.Open reduction, internal fixation with intramedullary rods, and external fixation are used for stabilization. Post-operative imaging confirms alignment., A patient with an unstable both-bone forearm fracture requiring ORIF. The surgeon uses a plate and screws for the radius fracture and an intramedullary nail for the ulna, necessitating a longer surgical time and increased complexity.

* Pre-operative assessment and imaging (X-rays) demonstrating the fracture.* Operative report detailing the surgical approach, reduction technique, fixation method, and intraoperative imaging.* Post-operative imaging to confirm fracture alignment and fixation stability.* Discharge instructions and follow-up plan.

** The use of external fixation in addition to internal fixation requires reporting 20690 and the appropriate internal fixation code, according to CPT guidelines.If the cast is removed by someone other than the physician who applied it, a separate cast removal code is required.

  • Revenue Code: P5B (AMBULATORY PROCEDURES - MUSCULOSKELETAL)
  • Payment Status: Active
  • Specialties:Orthopedic Surgery, Trauma Surgery
  • Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Hospital Outpatient
** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.