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Official Description

Closed treatment of ulnar styloid fracture

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 25650 refers to the closed treatment of an ulnar styloid fracture, which is a specific type of fracture occurring at the distal end of the ulna bone in the forearm. The ulnar styloid is a bony prominence located on the inner side of the wrist, and fractures in this area can result from various injuries, often involving falls or direct trauma. In the context of this procedure, 'closed treatment' indicates that the fracture is managed without surgical exposure, meaning that no incisions are made to access the fracture site directly. Instead, the treatment focuses on immobilizing the arm to allow for natural healing. During the evaluation of a nondisplaced or minimally displaced fracture, healthcare professionals perform a thorough neurovascular examination to ensure that the nerves and blood vessels surrounding the injury are intact and functioning properly. This is a critical step in the assessment process, as it helps to prevent complications that could arise from compromised blood flow or nerve damage. Following the evaluation, the arm is immobilized using a splint or cast to stabilize the fracture and promote healing. It is important to note that this code does not involve any manipulation of the fracture fragments, distinguishing it from other treatment options that may require more invasive techniques. Overall, the closed treatment of an ulnar styloid fracture aims to restore function and alleviate pain while minimizing the need for surgical intervention.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The closed treatment of an ulnar styloid fracture, as described by CPT® Code 25650, is indicated for specific conditions related to the fracture of the ulnar styloid. The following indications are explicitly recognized for this procedure:

  • Nondisplaced Fracture - This procedure is indicated for fractures that are not displaced, meaning the bone fragments remain in their normal anatomical position.
  • Minimally Displaced Fracture - The procedure is also applicable for minimally displaced fractures where there is slight movement of the bone fragments but not enough to require surgical intervention.

2. Procedure

The closed treatment of an ulnar styloid fracture involves several key procedural steps that ensure proper management of the injury. The following steps outline the process:

  • Step 1: Evaluation - The first step in the procedure is a comprehensive evaluation of the fracture. This includes obtaining separately reportable radiographs to confirm the presence of the fracture and assess its characteristics. A neurovascular examination is also performed to ensure that the nerves and blood vessels in the area are intact, which is crucial for preventing complications.
  • Step 2: Immobilization - Once the evaluation is complete and the fracture is confirmed, the next step is to immobilize the arm. This is typically achieved by applying a splint or cast to stabilize the fracture site. The immobilization is essential to prevent movement of the fracture fragments, allowing for natural healing to occur without the need for surgical intervention.

3. Post-Procedure

After the closed treatment of an ulnar styloid fracture, post-procedure care is focused on monitoring the healing process and ensuring that the immobilization remains effective. Patients are typically advised to keep the arm elevated and to avoid any activities that may stress the fracture site. Follow-up appointments are necessary to assess the healing progress through additional radiographs. If healing is progressing well, the splint or cast may be removed after a specified period, and rehabilitation exercises may be introduced to restore range of motion and strength in the wrist and forearm.

Short Descr CLTX ULNAR STYLOID FRACTURE
Medium Descr CLOSED TREATMENT ULNAR STYLOID FRACTURE
Long Descr Closed treatment of ulnar styloid fracture
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
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.
25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
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).
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.
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.)
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).
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
CR Catastrophe/disaster related
ET Emergency services
GC This service has been performed in part by a resident under the direction of a teaching physician
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
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)
SG Ambulatory surgical center (asc) facility service
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
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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2025-01-01 Changed Short Description changed.
Pre-1990 Added Code added.
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