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The CPT® Code 25635 refers to the closed treatment of a fracture involving one of the carpal bones, excluding the carpal scaphoid (navicular) bone, with the requirement of manipulation for each affected bone. Carpal bones are the eight small bones that make up the wrist, arranged in two rows: the proximal row includes the scaphoid, lunate, triquetrum, and pisiform, while the distal row consists of the trapezium, trapezoid, capitate, and hamate. When a fracture occurs in one of these bones, it can be treated through various methods, including closed treatment without manipulation, closed treatment with manipulation, or open treatment. In cases where multiple carpal bones are fractured, each fracture must be reported separately for accurate coding and billing. Prior to treatment, radiographs are obtained to confirm the presence and specifics of the fracture. A thorough neurovascular examination is also conducted to ensure that the nerves and blood vessels surrounding the injury are intact and functioning properly. The manipulation involved in CPT® Code 25635 specifically refers to the manual reduction of displaced fracture fragments back into their proper anatomical alignment, followed by the application of a short arm splint or cast to immobilize the wrist and facilitate healing.
© Copyright 2025 Coding Ahead. All rights reserved.
The closed treatment of carpal bone fractures, specifically under CPT® Code 25635, is indicated for patients presenting with a displaced fracture of one of the carpal bones, excluding the carpal scaphoid (navicular) bone. The procedure is typically performed when the fracture is confirmed through radiographic imaging, and there is a need for manipulation to restore proper alignment of the fractured bone. The indications for this procedure may include:
The procedure for CPT® Code 25635 involves several critical steps to ensure effective treatment of the displaced carpal bone fracture. The following procedural steps are outlined:
Following the closed treatment procedure under CPT® Code 25635, patients are typically advised on post-procedure care to ensure optimal recovery. This may include instructions on how to care for the splint or cast, signs of complications to watch for, and recommendations for follow-up appointments to monitor healing. Patients may also be advised to limit movement of the wrist and to avoid putting weight or stress on the affected area during the initial recovery phase. Regular follow-up radiographs may be necessary to confirm that the fracture is healing correctly and that the bone fragments remain in proper alignment.
| Short Descr | CLTX CARPL FX W/MNPJ EA B1 | Medium Descr | CLTX CARPAL BONE FX W/MNPJ EACH BONE | Long Descr | Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); with manipulation, each bone | 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) | P5B - Ambulatory 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. | 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. | 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.) | AG | Primary physician | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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Notes
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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| 2009-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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