© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 25690 refers to the closed treatment of a lunate dislocation, which is a specific type of wrist injury. A lunate dislocation occurs when the lunate bone, one of the carpal bones in the wrist, becomes displaced from its normal position, often as a result of trauma such as a fall onto an outstretched hand. This injury can lead to significant pain and dysfunction in the wrist. The closed treatment approach involves manually manipulating the dislocated bone back into its proper anatomical alignment without the need for surgical incisions. This procedure is typically accompanied by the use of radiographs, or X-rays, to confirm the presence of the dislocation and to ensure that the bone fragments are properly aligned after manipulation. Following the reduction, the wrist is immobilized in a cast to promote healing and prevent further injury. It is important to note that this code is distinct from CPT® Code 25695, which involves an open reduction procedure that requires surgical intervention. The closed treatment method represented by CPT® Code 25690 is generally less invasive and is often preferred when appropriate.
© Copyright 2025 Coding Ahead. All rights reserved.
The closed treatment of lunate dislocation, as described by CPT® Code 25690, is indicated for patients who present with a dislocated lunate bone in the wrist, typically following a traumatic event such as a fall onto an outstretched hand. The procedure is performed when the dislocation is diagnosed and confirmed through imaging studies, such as radiographs, which are necessary to assess the extent of the injury and to rule out associated fractures. The primary symptoms prompting this treatment include severe wrist pain, swelling, and limited range of motion, which are characteristic of a lunate dislocation.
The closed treatment of lunate dislocation involves several key procedural steps to ensure proper alignment and stabilization of the dislocated bone. Initially, the physician will assess the injury through a physical examination and obtain separate radiographs to confirm the diagnosis of lunate dislocation. Once the dislocation is verified, the physician will proceed with the closed reduction technique. This involves manually manipulating the wrist to reposition the lunate bone back into its anatomical location. The physician applies specific forces to the wrist to achieve the desired reduction while monitoring the patient's response to ensure comfort and safety. After the manipulation, a second set of radiographs is obtained to verify that the lunate has been successfully reduced and is in proper alignment. If the reduction is confirmed, the wrist is then immobilized in a cast to maintain the position of the lunate and facilitate healing. The cast is typically worn for a specified duration, during which the patient is advised on post-procedure care and follow-up appointments to monitor recovery.
After the closed treatment of lunate dislocation, patients are typically advised to keep the wrist immobilized in the cast for a specified period, which may vary based on the severity of the dislocation and the physician's recommendations. During this time, patients should avoid any activities that could stress the wrist or lead to re-injury. Follow-up appointments are essential to monitor the healing process, assess the alignment of the lunate, and determine when it is safe to remove the cast. Patients may also receive guidance on rehabilitation exercises to restore strength and range of motion once the cast is removed. It is important for patients to report any unusual symptoms, such as increased pain or swelling, to their healthcare provider promptly.
| Short Descr | CLTX LUNATE DISLC W/MNPJ | Medium Descr | CLOSED TX LUNATE DISLOCATION W/MANIPULATION | Long Descr | Closed treatment of lunate 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 | Hospital Part B services paid through a comprehensive APC | 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 | 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) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2025-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.