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The CPT® Code 23625 refers to the closed treatment of a fracture specifically located at the greater humeral tuberosity, which is a bony prominence on the upper part of the humerus (the bone of the upper arm). This procedure involves the manipulation of the fracture, meaning that the displaced fragments of the bone are manually adjusted back into their correct anatomical position. The term "closed treatment" indicates that this procedure does not require any surgical incisions; instead, it is performed externally. Prior to the treatment, radiographs (X-rays) are obtained to confirm the presence and extent of the fracture. This is crucial for ensuring that the treatment plan is appropriate for the specific type of fracture being addressed. In contrast to CPT® Code 23620, which pertains to nondisplaced fractures that do not require manipulation, CPT® Code 23625 is specifically for cases where the fracture is minimally displaced and necessitates manual reduction. Following the manipulation, the fracture site may be immobilized using a splint or cast to promote proper healing and alignment of the bone fragments.
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The closed treatment of a greater humeral tuberosity fracture with manipulation, as described by CPT® Code 23625, is indicated for specific conditions related to the fracture of the greater humeral tuberosity. The following indications are explicitly recognized for this procedure:
The procedure for the closed treatment of a greater humeral tuberosity fracture with manipulation involves several key steps, which are detailed as follows:
Following the closed treatment procedure, the patient will require specific post-procedure care to ensure proper recovery. The immobilization device, such as a splint or cast, should remain in place for the duration recommended by the physician, which may vary based on the severity of the fracture and the patient's overall health. Regular follow-up appointments are necessary to monitor the healing process, which may include additional radiographs to confirm that the fracture is healing correctly and that the alignment is maintained. Patients are typically advised to limit movement of the affected arm to prevent stress on the healing bone. Pain management strategies may also be discussed, and the physician may provide guidance on rehabilitation exercises to restore function once the fracture has sufficiently healed.
| Short Descr | CLTX GR HMRL TBRS FX W/MNPJ | Medium Descr | CLTX GREATER HUMRL TUBEROSITY FX W/MANIPULATION | Long Descr | Closed treatment of greater humeral tuberosity fracture; with manipulation | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 148 - Other fracture and dislocation procedure |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 55 | Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2023-01-01 | Note | Short and medium descriptions changed. |
| Pre-1990 | Added | Code added. |
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