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A trans-scaphoperilunar type fracture dislocation, commonly known as a Mayfield fracture dislocation, is a specific and rare injury that occurs in the wrist. This type of injury typically results from a high-energy impact, which can lead to significant trauma. The injury is characterized by a fracture of the scaphoid bone, which is one of the small bones in the wrist, along with a dislocation of the lunate bone, another critical component of wrist anatomy. The closed treatment procedure described by CPT® Code 25680 involves the manual manipulation of the fractured scaphoid and dislocated lunate to restore their anatomical alignment without the need for surgical incisions. Prior to the treatment, separate radiographs are obtained to confirm the presence of the fracture and dislocation. Following the manipulation, a second set of radiographs is taken to ensure that the bones have been properly aligned. Once the anatomical reduction is verified, the wrist is immobilized in a cast to facilitate healing and prevent further injury during the recovery process.
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The closed treatment of a trans-scaphoperilunar type fracture dislocation is indicated in the following scenarios:
The closed treatment procedure for a trans-scaphoperilunar type fracture dislocation involves several critical steps to ensure proper alignment and healing of the wrist bones:
After the closed treatment procedure, the patient will typically be monitored for any signs of complications. The wrist will remain immobilized in a cast for a specified duration to allow for proper healing of the scaphoid fracture and lunate dislocation. Follow-up appointments are necessary to assess the healing process through additional radiographs and to ensure that the bones remain in the correct position. Patients may also receive instructions on pain management and activity restrictions during the recovery period to promote optimal healing and prevent further injury.
| Short Descr | CLTX TRNS-SCPHPRLNR FX MNPJ | Medium Descr | CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MNPJ | Long Descr | Closed treatment of trans-scaphoperilunar type of fracture 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 | 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. | 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. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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) | 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 and Medium Descriptions changed. |
| Pre-1990 | Added | Code added. |
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