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Official Description

Closed treatment of radial shaft fracture; with manipulation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Closed treatment of a radial shaft fracture involves a non-surgical approach to address a break in the radial bone, which is located in the forearm. This procedure is specifically indicated for fractures that may be minimally displaced, meaning that the bone fragments have shifted slightly but can be realigned without the need for surgical intervention. During the treatment, the physician will perform a manipulation of the fracture fragments to restore them to their correct anatomical position. This is a critical step, as proper alignment is essential for optimal healing and function of the arm. Following the manipulation, the physician will apply a long arm splint or cast to immobilize the arm, ensuring that the fracture remains stable during the healing process. Additionally, radiographs, or X-rays, are obtained to confirm the presence of the fracture and to verify that the manipulation has successfully restored the bone to its proper alignment. A thorough neurovascular examination is also conducted to assess the integrity of the nerves and blood vessels surrounding the injury site, ensuring that there are no complications that could affect recovery.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Closed treatment of a radial shaft fracture with manipulation is indicated for the following conditions:

  • Minimally Displaced Fracture A fracture of the radial shaft that has slight displacement, requiring manual manipulation to restore proper alignment.
  • Fracture Confirmation The procedure is performed when radiographs confirm the presence of a radial shaft fracture.
  • Neurovascular Integrity Indicated when a neurovascular examination shows that the nerves and blood vessels at the injury site are intact.

2. Procedure

The closed treatment of a radial shaft fracture with manipulation involves several key procedural steps:

  • Step 1: Initial Assessment The physician begins with a thorough assessment of the patient's injury, including a detailed history and physical examination. This includes evaluating the arm for signs of fracture and assessing the range of motion, as well as performing a neurovascular exam to ensure that the nerves and blood vessels are functioning properly.
  • Step 2: Radiographic Confirmation Following the initial assessment, the physician orders radiographs (X-rays) to confirm the diagnosis of a radial shaft fracture. These images are crucial for determining the extent of the fracture and the degree of displacement.
  • Step 3: Manipulation of Fracture Fragments If the fracture is determined to be minimally displaced, the physician will proceed with the manipulation of the fracture fragments. This involves manually adjusting the bone fragments back into their correct anatomical alignment to promote proper healing.
  • Step 4: Immobilization Once the fracture fragments are aligned, the physician applies a long arm splint or cast to immobilize the arm. This immobilization is essential to prevent further movement of the fracture site, allowing for optimal healing.
  • Step 5: Follow-Up Radiographs After the application of the splint or cast, additional radiographs may be obtained to confirm that the manipulation has successfully restored the fracture to its proper alignment.

3. Post-Procedure

Post-procedure care for a closed treatment of a radial shaft fracture with manipulation includes monitoring the patient for any signs of complications, such as increased pain, swelling, or changes in neurovascular status. The patient is typically advised to keep the arm elevated and to follow specific instructions regarding the care of the splint or cast. Follow-up appointments are essential to assess the healing process and to obtain further radiographs as needed to ensure that the fracture is healing correctly. The duration of immobilization may vary based on the individual case and the physician's assessment of healing progress.

Short Descr CLTX RDL SHFT FX W/MNPJ
Medium Descr CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION
Long Descr Closed treatment of radial shaft 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 145 - Treatment, fracture or dislocation of radius and ulna
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
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.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
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.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
RT Right side (used to identify procedures performed on the right side of the body)
T1 Left foot, second digit
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
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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2025-01-01 Changed Short Description changed.
Pre-1990 Added Code added.
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