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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; with manipulation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 25605 refers to the closed treatment of a distal radial fracture, which may include types such as Colles or Smith fractures, or an epiphyseal separation. This procedure is characterized by the closed treatment approach, meaning that no surgical incision is made to access the fracture site. 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 trauma. The procedure involves the manipulation of the fracture fragments to restore proper alignment, which is crucial for optimal healing and function. The term 'manipulation' indicates that the physician will apply manual traction and force to reposition the fractured bone fragments into their correct anatomical position. Additionally, the procedure necessitates the acquisition of radiographs, or X-rays, to confirm the presence of the fracture or epiphyseal separation and to ensure that the alignment has been successfully restored post-manipulation. This code is distinct from CPT® Code 25600, which pertains to the treatment of nondisplaced fractures that do not require manipulation. Overall, CPT® Code 25605 encompasses a critical intervention for managing specific types of fractures in the distal radius, ensuring that patients receive appropriate care to facilitate recovery.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The closed treatment of distal radial fractures or epiphyseal separations is indicated for patients presenting with specific types of fractures or injuries to the distal radius. The following conditions warrant the use of CPT® Code 25605:

  • Distal Radial Fracture This includes fractures such as Colles fractures, which typically occur due to a fall on an outstretched hand, and Smith fractures, which result from a fall onto a flexed wrist.
  • Epiphyseal Separation This condition is particularly relevant in pediatric patients, where the growth plate or cartilaginous epiphysis separates from the bone, leading to potential growth disturbances if not treated properly.
  • Fracture of the Ulnar Styloid If present, a fracture of the ulnar styloid may also be treated during the procedure, as it is often associated with distal radial fractures.

2. Procedure

The procedure for CPT® Code 25605 involves several critical steps to ensure effective treatment of the fracture:

  • Initial Assessment The physician begins with a thorough evaluation of the patient's injury, including a neurovascular examination to assess the integrity of nerves and blood vessels in the affected area. This step is crucial to rule out any complications that may arise from the fracture.
  • Radiographic Imaging Following the initial assessment, separate radiographs are obtained to confirm the diagnosis of a distal radial fracture or epiphyseal separation. These images provide essential information regarding the fracture's characteristics and displacement.
  • Closed Reduction If the fracture is determined to be minimally displaced, the physician will perform a closed reduction. This involves manually manipulating the fracture fragments back into their proper anatomical alignment using traction and controlled force. The goal is to restore the normal alignment of the bone without the need for surgical intervention.
  • Immobilization Once the fracture fragments are aligned, the arm is immobilized using a splint or cast. This immobilization is critical for protecting the fracture site and allowing for proper healing.
  • Post-Reduction Imaging After immobilization, additional radiographs may be obtained to confirm that the fracture has been adequately reduced and is in the correct position for healing.

3. Post-Procedure

Post-procedure care for patients undergoing CPT® Code 25605 includes monitoring for any signs of complications, such as improper healing or neurovascular compromise. Patients are typically advised on the importance of keeping the arm immobilized and may receive instructions on pain management and activity restrictions. Follow-up appointments are essential to assess healing progress and to determine when the cast or splint can be safely removed. Rehabilitation exercises may be recommended once healing is confirmed to restore strength and range of motion in the affected arm.

Short Descr CLTX DST RDL FX/EPHYS SEP W/
Medium Descr CLTX DSTL RDL FX/EPIPHYSL SEP W/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; 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
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.
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
GC This service has been performed in part by a resident under the direction of a teaching physician
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).
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.
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
47 Anesthesia by surgeon: regional or general anesthesia provided by the surgeon may be reported by adding modifier 47 to the basic service. (this does not include local anesthesia.) note: modifier 47 would not be used as a modifier for the anesthesia procedures.
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).
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).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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).
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.
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.
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AG Primary physician
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
FA Left hand, thumb
FS Split (or shared) evaluation and management visit
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
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
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
SA Nurse practitioner rendering service in collaboration with a physician
SG Ambulatory surgical center (asc) facility service
TT Individualized service provided to more than one patient in same setting
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
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
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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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