© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 25520 involves the closed treatment of a radial shaft fracture in conjunction with the closed treatment of a dislocation of the distal radioulnar joint, commonly known as a Galeazzi fracture-dislocation. This type of injury typically occurs when there is a fracture in the radial shaft, which is the larger of the two bones in the forearm, along with a dislocation at the distal end of the radius where it meets the ulna at the wrist. The closed treatment approach means that the procedure is performed without making any incisions, utilizing manual manipulation to realign the bones. Prior to treatment, radiographs, or X-rays, are obtained to confirm the presence of the fracture and dislocation. A thorough neurovascular examination is conducted to assess the integrity of the nerves and blood vessels surrounding the injury, ensuring that there are no complications that could affect healing or function. The treatment begins with the application of longitudinal traction to correct any angulation of the radial shaft fracture. Once the fracture is properly aligned, the healthcare provider evaluates the distal radioulnar joint through imaging to check if the dislocation has spontaneously reduced during the manipulation. If the dislocation persists, further manual manipulation is performed to restore proper alignment. Following the successful reduction of both the fracture and dislocation, additional radiographs are taken to verify that both injuries have been adequately addressed. Finally, a long arm splint or cast is applied to immobilize the arm, facilitating the healing process and preventing further injury.
© Copyright 2025 Coding Ahead. All rights reserved.
The closed treatment of a radial shaft fracture with a dislocation of the distal radioulnar joint is indicated in the following scenarios:
The procedure for CPT® Code 25520 involves several critical steps to ensure effective treatment of the injuries:
After the procedure, the patient is monitored for any signs of complications, including issues related to neurovascular integrity. The immobilization provided by the splint or cast is crucial for the healing of both the radial shaft fracture and the distal radioulnar joint dislocation. Patients are typically advised on care instructions for the splint or cast, including keeping it dry and clean, and are informed about signs of complications that may require immediate medical attention. Follow-up appointments are necessary to assess healing through additional radiographs and to determine when it is appropriate to begin rehabilitation exercises to restore function and strength to the affected arm.
| Short Descr | CLTX RDL SHFT FX&DISLC | Medium Descr | CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT | Long Descr | Closed treatment of radial shaft fracture and closed treatment of dislocation of distal radioulnar joint (Galeazzi fracture/dislocation) | 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) | P3D - Major procedure, orthopedic - other | 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). | 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.) | 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) |
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Notes
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| 2025-01-01 | Changed | Short Description changed. |
| 2002-01-01 | Changed | Code description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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