2025 CPT code 25609
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Fracture and/or Dislocation Procedures on the Forearm and Wrist Musculoskeletal System Feed
Open treatment of a distal radial intra-articular fracture or epiphyseal separation with internal fixation of 3 or more fragments.
Modifiers may be appended to 25609 as clinically indicated, such as modifier 22 (increased procedural services), 51 (multiple procedures), 52 (reduced services), 59 (distinct procedural service), or 76 (repeat procedure).Appropriate modifier use should be supported by detailed documentation.
Medical necessity for 25609 is established when a distal radial fracture, involving the joint surface or growth plate, demonstrates instability or displacement that significantly impacts function and requires surgical intervention for adequate reduction and stable fixation. The multiple fragments necessitate open surgical repair for proper alignment and healing.
The surgeon is responsible for performing the open surgical procedure, including the incision, fracture reduction (manipulation of bone fragments), internal fixation (placement of screws, wires, or pins), hemostasis (control of bleeding), and wound closure.Pre- and postoperative care may be provided by other healthcare professionals.
- Musculoskeletal System
- Surgical Procedures on the Musculoskeletal System > Surgical Procedures on the Forearm and Wrist > Fracture and/or Dislocation Procedures on the Forearm and Wrist
In simple words: This code covers surgery to fix a broken bone in the lower part of the radius (one of the two bones in your forearm), especially if the break involves the wrist joint.The surgeon opens the skin to see the break, puts the broken pieces back together, and holds them in place with small metal devices such as screws or wires.
This CPT code describes the open surgical treatment of a distal radial fracture involving the joint surface (intra-articular) or the growth plate (epiphyseal separation) requiring internal fixation of at least three bone fragments. The procedure involves surgically opening the fracture site, manipulating the fragments into proper alignment, and stabilizing them using internal fixation devices such as screws, wires, or pins.The code encompasses the surgical approach, fracture reduction, internal fixation, and wound closure.
Example 1: A patient presents with a severely comminuted (multiple fragment) distal radial fracture after a fall.The surgeon performs an open reduction and internal fixation (ORIF) using multiple screws to stabilize the fracture fragments.This scenario necessitates code 25609., A patient sustains an open distal radial fracture with three displaced fragments during a motor vehicle accident.The surgeon performs an open procedure, including fracture reduction and internal fixation with Kirschner wires and screws.25609 is the appropriate code., A young athlete suffers an epiphyseal separation (separation of the growth plate) of the distal radius with multiple fragments after a sports injury.Open surgery, reduction, and fixation with mini-plates and screws are performed, and 25609 accurately reflects the procedure.
The operative report must clearly document the open nature of the procedure, the intra-articular or epiphyseal involvement, and the number of fragments requiring internal fixation (minimum three).Preoperative and postoperative imaging (x-rays), details of the surgical technique used, and the type and number of fixation devices implanted should all be documented.
** The number of fragments is critical for accurate code selection.Ensure that the operative report specifies the number of fragments fixed.The type of fracture (open or closed) does not determine the type of treatment (open or closed). Closed fractures may require open reduction and internal fixation.
- Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
- RVU: The RVUs for this code vary based on geographic location, facility type, and other factors. Consult the appropriate fee schedule for the most accurate value.
- Global Days : The global period for this procedure is typically 90 days.During this time, follow-up visits and some minor procedures related to the initial fracture repair may be included in the global fee.Additional procedures or services outside the 90-day period may be billed separately.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not typically applicable to this code, as it refers to a complete surgical procedure.
- Fee Schedule : Historical fee schedule data will vary by payer and location.Consult your payer's fee schedule for specific historical data.
- Specialties:Orthopedic Surgery, Hand Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital