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Closed treatment of a carpal scaphoid fracture, also known as a navicular fracture, involves a non-surgical approach to address a fracture of the scaphoid bone, which is one of the eight carpal bones in the wrist. This bone is situated at the base of the thumb and is recognized as the most commonly fractured bone in the wrist due to its location and the forces exerted on it during wrist injuries. The procedure is indicated when there is a minimally displaced fracture, meaning that the fracture fragments have not significantly shifted from their normal anatomical position. Prior to the treatment, radiographs, or X-rays, are obtained to confirm the presence of the fracture, although it is important to note that scaphoid fractures may not be visible on these images until one to two weeks after the injury occurs. A thorough neurovascular examination is conducted to assess the integrity of the nerves and blood vessels surrounding the injury site, ensuring that there are no complications that could affect healing. In cases where the fracture is nondisplaced, as described in CPT® Code 25622, no manipulation is necessary, and the arm is typically immobilized with a short arm splint or cast. However, for CPT® Code 25624, which pertains to the closed treatment of a minimally displaced fracture, the procedure includes the manual manipulation of the fracture fragments to restore proper anatomical alignment. Following this manipulation, additional radiographs are taken to verify that the alignment has been successfully achieved, and the arm is then immobilized using a short arm splint or cast to facilitate healing.
© Copyright 2025 Coding Ahead. All rights reserved.
The closed treatment of a carpal scaphoid fracture with manipulation is indicated for patients presenting with a minimally displaced fracture of the scaphoid bone. This procedure is typically performed when the fracture is confirmed through radiographic imaging, and the patient exhibits symptoms such as wrist pain, swelling, and limited range of motion. The manipulation is necessary to realign the fracture fragments to promote proper healing and restore function.
The closed treatment of a carpal scaphoid fracture with manipulation involves several key procedural steps to ensure effective treatment and recovery. Initially, the patient undergoes a thorough evaluation, including a neurovascular examination to assess the integrity of the nerves and blood vessels in the area of the injury. Following this assessment, radiographs are obtained to confirm the diagnosis of a minimally displaced scaphoid fracture. Once the fracture is confirmed, the physician proceeds with the manipulation of the fracture fragments. This step involves manually adjusting the displaced fragments back into their proper anatomical alignment, which is crucial for optimal healing. After achieving the desired alignment, additional radiographs are taken to verify that the manipulation has been successful and that the fracture fragments are correctly positioned. Finally, to immobilize the arm and facilitate healing, a short arm splint or cast is applied, ensuring that the wrist remains stable during the recovery process.
After the closed treatment of a carpal scaphoid fracture with manipulation, the patient is advised on post-procedure care to ensure optimal recovery. The immobilization device, such as a short arm splint or cast, must remain in place for a specified duration to protect the fracture site and promote healing. Patients are typically instructed to avoid any activities that may place stress on the wrist during the healing period. Follow-up appointments are essential to monitor the healing process, and additional radiographs may be performed to assess the alignment and healing of the fracture. Patients should also be aware of signs of complications, such as increased pain, swelling, or changes in sensation, and are encouraged to report these to their healthcare provider promptly. Overall, adherence to post-procedure instructions is critical for a successful recovery and restoration of wrist function.
| Short Descr | CLTX CARPL SCPHD FX W/MNPJ | Medium Descr | CLOSED TX CARPAL SCAPHOID FRACTURE W/MNPJ | Long Descr | Closed treatment of carpal scaphoid (navicular) 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) | 0 - 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) | P6B - Minor 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. | 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | FA | Left hand, thumb | 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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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| Pre-1990 | Added | Code added. |
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