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Closed treatment of radiocarpal or intercarpal dislocation, as described by CPT® Code 25660, refers to a specific medical procedure aimed at addressing dislocations of the wrist bones, which include the radiocarpal and intercarpal joints. These types of dislocations are considered rare and typically occur as a result of high-energy impacts, such as those experienced in sports injuries or accidents. The procedure begins with the physician obtaining separate radiographs, or X-rays, to assess the extent of the dislocation and to evaluate any potential damage to the surrounding bones, ligaments, and soft tissues of the wrist. Following this assessment, a closed reduction is performed, which involves the manual manipulation of the dislocated bones back into their correct anatomical positions without the need for surgical incisions. After the closed reduction, it is common practice to obtain a second set of radiographs to confirm that the carpal bones have been successfully realigned. To support the healing process and prevent further injury, a cast is usually applied to immobilize the wrist. This procedure is distinct from open reduction techniques, such as those described in CPT® Code 25670, which may involve surgical intervention and the use of suture anchors or stabilization devices like pins or K-wires, depending on the specific carpal bones affected.
© Copyright 2025 Coding Ahead. All rights reserved.
The closed treatment of radiocarpal or intercarpal dislocation, coded as CPT® 25660, is indicated for patients presenting with dislocations of the wrist joints. These dislocations may arise from various high-energy trauma events, leading to significant pain, swelling, and functional impairment of the wrist. The procedure is typically performed when the dislocation is diagnosed through clinical evaluation and imaging studies, and when the physician determines that a closed reduction is appropriate based on the nature and severity of the dislocation.
The procedure for closed treatment of radiocarpal or intercarpal dislocation involves several critical steps to ensure proper alignment and healing of the wrist bones. Initially, the physician will obtain separate radiographs to assess the dislocation's extent and to evaluate any associated injuries to the ligaments and soft tissues surrounding the wrist. Once the evaluation is complete, the physician will proceed with the closed reduction. This step involves the careful manual manipulation of the dislocated bones back into their correct anatomical positions. The physician applies specific techniques to ensure that the bones are realigned without the need for surgical intervention. Following the closed reduction, a second set of radiographs is often obtained to verify that the carpal bones have been successfully repositioned. If the reduction is confirmed, the physician will then apply a cast to the wrist to immobilize the area, which is essential for preventing reinjury and allowing the ligaments to heal properly. This entire process is performed with the goal of restoring function to the wrist while minimizing the risk of complications.
After the closed treatment of radiocarpal or intercarpal dislocation, patients are typically monitored for any immediate complications. The application of a cast is crucial, as it provides the necessary support to the wrist during the healing process. Patients are advised to keep the cast dry and to avoid any activities that may stress the wrist during the recovery period. Follow-up appointments are essential to assess the healing progress, and additional radiographs may be taken to ensure that the bones remain in the correct position. The expected recovery time can vary depending on the severity of the dislocation and the individual patient's healing response. Rehabilitation exercises may be recommended once the cast is removed to restore strength and range of motion to the wrist.
| Short Descr | CLTX RDCRPL/NTRCRPL DISLC 1+ | Medium Descr | CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MNPJ | Long Descr | Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, 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 | Procedure or Service, Multiple Reduction Applies | 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 |
| 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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 | 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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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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