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Official Description

Closed treatment of distal radioulnar dislocation with manipulation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 25675 refers to the closed treatment of a distal radioulnar joint (DRUJ) dislocation with manipulation. A DRUJ dislocation occurs when the distal end of the ulna and the radius bones in the forearm become misaligned at the wrist joint. This type of dislocation is relatively uncommon and can occur without any accompanying fractures. The dislocation can be classified as either dorsal or volar; a dorsal dislocation typically results from hyperpronation of the forearm, while a volar dislocation is often caused by hypersupination. To accurately assess the injury, separate radiographic imaging is performed, which helps in determining the extent of the dislocation. The procedure described by CPT® Code 25675 involves manually reducing the dislocated joint. For a dorsal dislocation, the forearm is rotated into a supinated position while applying direct pressure to the ulna to facilitate realignment. Conversely, for a volar dislocation, the ulna is moved dorsally while the forearm is pronated. Following the successful reduction of the dislocation, the wrist is immobilized using a cast to ensure stability during the healing process.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The closed treatment of distal radioulnar dislocation with manipulation (CPT® Code 25675) is indicated for the following conditions:

  • Distal Radioulnar Joint Dislocation This procedure is performed when there is a dislocation of the distal radioulnar joint without any associated fractures.
  • Dorsal Dislocation Indicated when the dislocation is dorsal, typically resulting from hyperpronation of the forearm.
  • Volar Dislocation Indicated when the dislocation is volar, usually caused by hypersupination of the forearm.

2. Procedure

The procedure for closed treatment of distal radioulnar dislocation with manipulation involves several key steps:

  • Step 1: Assessment and Imaging Prior to the manipulation, the physician assesses the dislocation and obtains separate radiographs to evaluate the extent of the injury. This imaging is crucial for confirming the diagnosis and planning the treatment approach.
  • Step 2: Manual Reduction for Dorsal Dislocation If the dislocation is identified as dorsal, the forearm is positioned in a supinated manner. The physician applies direct pressure over the ulna to facilitate the manual reduction of the dislocated joint back into its proper alignment.
  • Step 3: Manual Reduction for Volar Dislocation In cases of volar dislocation, the procedure involves mobilizing the ulna dorsally while the forearm is pronated. This manipulation helps to realign the joint effectively.
  • Step 4: Immobilization After successful reduction of the dislocation, the wrist is immobilized in a cast. This immobilization is essential to maintain the joint's stability during the healing process and to prevent any recurrence of the dislocation.

3. Post-Procedure

Post-procedure care following the closed treatment of a distal radioulnar dislocation includes monitoring the patient for any signs of complications, ensuring that the cast remains intact, and providing instructions for care of the cast. Patients are typically advised to limit movement of the wrist and forearm to promote healing. Follow-up appointments are necessary to assess the healing process and to determine when the cast can be removed. Rehabilitation exercises may be recommended after cast removal to restore range of motion and strength in the wrist and forearm.

Short Descr CLTX DSTL RAD/ULN DISLC MNPJ
Medium Descr CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MNPJ
Long Descr Closed treatment of distal radioulnar dislocation 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
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.
LT Left side (used to identify procedures performed on the left side of the body)
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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
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.)
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
FS Split (or shared) evaluation and management visit
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
RT Right side (used to identify procedures performed on the right side of the body)
TG Complex/high tech level of care
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
Date
Action
Notes
2025-01-01 Changed Short and Medium Descriptions changed.
Pre-1990 Added Code added.
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