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Official Description

Open treatment of ulnar styloid fracture

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 25652 refers to the open treatment of an ulnar styloid fracture. The ulnar styloid is a bony prominence located at the distal end of the ulna, one of the two long bones in the forearm. When a fracture occurs in this area, it can lead to pain, swelling, and impaired function of the wrist and hand. Open treatment is indicated for displaced fractures, where the bone fragments are not aligned properly and require surgical intervention to restore their normal position. This procedure involves making an incision in the skin to access the fracture site directly, allowing for a thorough examination and manipulation of the bone fragments. During the surgery, the surgeon will clear any debris from the fracture site and ensure that the fragments are properly aligned. To maintain this alignment, various fixation methods such as a small fragmentation screw, intraosseous wiring, or tension banding may be utilized. After the fracture has been stabilized, a cast is applied to immobilize the arm, promoting healing and preventing further injury. This open approach is essential for achieving optimal outcomes in cases where less invasive methods, such as closed treatment or percutaneous fixation, are insufficient to address the fracture effectively.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The open treatment of an ulnar styloid fracture, as described by CPT® Code 25652, is indicated for specific conditions related to the fracture. These include:

  • Displaced Fracture: This procedure is performed when the fracture fragments of the ulnar styloid are misaligned and require surgical intervention to restore proper anatomical positioning.
  • Inadequate Response to Conservative Treatment: If a displaced fracture does not respond adequately to non-surgical methods such as closed treatment or percutaneous fixation, open treatment may be necessary.
  • Presence of Complications: Complications such as significant pain, instability, or functional impairment may warrant the need for surgical intervention to ensure proper healing and recovery.

2. Procedure

The open treatment of an ulnar styloid fracture involves several critical procedural steps, which are detailed as follows:

  • Step 1: Anesthesia Administration The procedure begins with the administration of appropriate anesthesia to ensure the patient is comfortable and pain-free during the surgery. This may involve local or general anesthesia, depending on the complexity of the case and the surgeon's preference.
  • Step 2: Incision A surgical incision is made through the skin, typically located between the extensor carpi ulnaris (ECU) and flexor carpi ulnaris (FCU) tendons. This strategic placement allows for optimal access to the fracture site while minimizing damage to surrounding tissues.
  • Step 3: Fracture Site Identification Once the incision is made, the surgeon carefully dissects through the soft tissue to identify the fracture site. This step is crucial for ensuring that the fracture fragments can be adequately visualized and manipulated.
  • Step 4: Debris Clearance The fracture site is then cleared of any debris or hematoma that may obstruct the view or interfere with the reduction process. This ensures a clean working area for the surgeon.
  • Step 5: Reduction of Fracture Fragments The surgeon proceeds to reduce the fracture fragments, aligning them back to their normal anatomical position. This step is critical for restoring function and stability to the wrist.
  • Step 6: Stabilization of Fracture To maintain the proper alignment of the fracture fragments, the surgeon may utilize various fixation methods, including the placement of a small fragmentation screw, intraosseous wiring, or tension banding. These techniques help secure the fragments in place during the healing process.
  • Step 7: Application of Cast After the fracture has been stabilized, a cast is applied to immobilize the arm. This immobilization is essential for promoting healing and preventing any movement that could disrupt the alignment of the fracture.

3. Post-Procedure

Following the open treatment of an ulnar styloid fracture, several post-procedure care considerations are essential for optimal recovery. The patient will typically be monitored for any immediate complications related to the surgery, such as infection or excessive bleeding. Pain management will be addressed, and the patient may be prescribed analgesics to manage discomfort. The cast will remain in place for a specified duration, during which the patient is advised to limit movement of the affected arm to facilitate healing. Follow-up appointments will be necessary to assess the healing process through radiographic imaging and to determine when the cast can be removed. Rehabilitation exercises may be recommended after cast removal to restore strength and range of motion in the wrist and hand.

Short Descr OPTX ULNAR STYLOID FRACTURE
Medium Descr OPEN TREATMENT ULNAR STYLOID FRACTURE
Long Descr Open 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) 1 - Co-surgeons could be paid, though supporting documentation is required...
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 Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
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
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
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).
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.
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.)
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)
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)
SG Ambulatory surgical center (asc) facility service
UB Medicaid level of care 11, as defined by each state
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 Description changed.
2002-01-01 Added First appearance in code book in 2002.
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