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Official Description

Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 25600 refers to the closed treatment of a distal radial fracture, which may include types such as Colles or Smith fractures, as well as epiphyseal separations. This procedure is characterized by the absence of manipulation, meaning that the fractured bone fragments are not physically repositioned during the treatment. In cases where a fracture of the ulnar styloid is present, this treatment is also included. Distal radial fractures are common injuries that occur in the forearm, typically resulting from falls or direct impacts. The three primary types of distal forearm fractures include the extension or Colles fracture, which occurs when the wrist is extended at the time of injury; the flexion or Smith fracture, which occurs when the wrist is flexed; and the push-off fracture, also known as Barton's or Hutchinson's fracture. In pediatric patients, epiphyseal separation can occur when the growth plate, which is the area of developing tissue at the ends of long bones, becomes separated or fractured. To confirm the diagnosis of a fracture or epiphyseal separation, separate radiographs are obtained. A thorough neurovascular examination is also performed to assess the integrity of the nerves and blood vessels surrounding the injury site. In the context of CPT® Code 25600, the focus is on the evaluation and treatment of a nondisplaced fracture of the distal radius, with or without an associated ulnar styloid fracture, without the need for manipulation. The treatment typically involves immobilization of the arm using a splint or cast to promote healing.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The closed treatment of a distal radial fracture or epiphyseal separation is indicated in the following scenarios:

  • Distal Radial Fracture This procedure is performed for patients presenting with a distal radial fracture, which may include specific types such as Colles or Smith fractures.
  • Epiphyseal Separation Indicated for children who experience an epiphyseal separation, where the growth plate has either separated or fractured off the bone.
  • Ulnar Styloid Fracture When a fracture of the ulnar styloid is present, this treatment is also applicable as part of the closed treatment process.

2. Procedure

The procedure for CPT® Code 25600 involves several key steps that ensure proper treatment of the fracture:

  • Initial Assessment The healthcare provider begins with a thorough assessment of the patient's injury, including a detailed history and physical examination. This includes a neurovascular exam to check the integrity of the nerves and blood vessels in the affected area.
  • Radiographic Evaluation Separate radiographs are obtained to confirm the presence of a distal radial fracture or epiphyseal separation. These imaging studies are crucial for determining the exact nature and extent of the injury.
  • Closed Treatment Once the diagnosis is confirmed, the closed treatment of the fracture is initiated. In this case, no manipulation of the fracture fragments is performed, as the focus is on treating a nondisplaced fracture.
  • Immobilization The arm is then immobilized using a splint or cast. This immobilization is essential to ensure that the fracture heals properly and to prevent any movement that could disrupt the healing process.

3. Post-Procedure

After the closed treatment procedure, the patient will typically be monitored for any signs of complications. The immobilization device, whether a splint or cast, will need to remain in place for a specified duration to allow for proper healing of the fracture. Follow-up appointments are necessary to assess the healing process through additional radiographs and to ensure that the fracture remains stable. Patients may also receive instructions on pain management and activity restrictions during the recovery period to promote optimal healing and prevent further injury.

Short Descr CLTX DST RDL FX/EPHYS SEP WO
Medium Descr CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ
Long Descr Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without 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 Procedure or Service, Multiple Reduction Applies
ASC Payment Indicator Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6B - Minor procedures - musculoskeletal
MUE 1
CCS Clinical Classification 145 - Treatment, fracture or dislocation of radius and ulna
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)
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.
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.
GC This service has been performed in part by a resident under the direction of a teaching physician
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.
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
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
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).
56 Preoperative management only: when 1 physician or other qualified health care professional performed the preoperative care and evaluation and another performed the surgical procedure, the preoperative component may be identified by adding modifier 56 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.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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.)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AF Specialty physician
AG Primary physician
AI Principal physician of record
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
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
ER Items and services furnished by a provider-based, off-campus emergency department
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F8 Right hand, fourth digit
FA Left hand, thumb
FS Split (or shared) evaluation and management visit
GF Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital
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
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
PN Non-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
QJ Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
SA Nurse practitioner rendering service in collaboration with a physician
SG Ambulatory surgical center (asc) facility service
TL Early intervention/individualized family service plan (ifsp)
U2 Medicaid level of care 2, as defined by each state
U7 Medicaid level of care 7, as defined by each state
X1 Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care
X2 Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2025-01-01 Changed Short and Medium Descriptions changed.
2007-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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