25609 cpt code description Every vignette contains a Clinical Example/Typical Patient and a description of Procedure/Intra-service. com - Maintenance Nov 14, 2025 · Master orthopedic medical billing and coding with essential CPT codes, guidelines, and tips to improve your orthopedic practice's revenue cycle. 72 for CPT codes 25609-LT, 25290-LT, 64415-59-LT and C1713. Code 25650 should never be reported alongside CPT codes 25600, 25605, or 25607-25609. CPT Code 25609 CPT 25609 describes the open treatment of a distal radial intra-articular fracture or epiphyseal separation with internal fixation of three or more fragments. 95 for codes 25609-LT and 25290-LT. 2 days ago · AMA CPT ® Assistant - 2007 Issue 10 (October) Fracture and/or Dislocation - Distal Radius (October 2007) October 2007 pages 7-10 Coding Communication:Fracture and/or Dislocation - Distal Radius Fractures of the distal radius are the most common fractures of the upper extremity and account for 17% of all fractures treated in the emergency department. How To Use CPT Code 25607 This Content Might Be Outdated - Check in Our Free Code Lookup Tool Medical codes change frequently, and using outdated information can lead to denials. The CPT 25609 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. Common Language Description The CPT® Code 25608 refers to the open treatment of a distal radial intra-articular fracture or epiphyseal separation, specifically involving the internal fixation of two fragments. Below is a list of potential modifiers that could be used with CPT code 25280, along with the reasons for their use: 1. In simpler terms, this procedure addresses fractures or separations at the distal end of the radius, which is the outer bone of the forearm located near the wrist. We began the procedure by removing her cast on the Oct 16, 2024 · Can I bill for using intraoperative fluoroscopy (C-arm) to assist in hardware placement before, during and after the procedure? The images are all taken while in the operating room. , Colles or Smith type] or epiphyseal separation, includes closed treat What is CPT Code 25609 CPT code 25609 is used to describe the treatment of a fracture in the radius bone that involves three or more fragments. Use official Procedure Price Lookup tool to compare national average to Medicare costs in ambulatory surgical centers, hosptial outpatient departments Oct 24, 2024 · Wiki 25609 ORIF distal radial intra-articular fx w/int fix of 3 or more fragments re: 25608 vs 25609 these 2 codes are referring to the fragments being Internally fixed this is the lay descriptions for the codes 25607-25609 ( 25607, 25608, 25609) The physician makes a 7. 43, which also is reported. An NCCI edit exists, so modifier 59 is appended in the presence of documentation. Aug 7, 2009 · I'm needing some input on billing a tentomy with wrist fracture code 25609. Aug 3, 2025 · This guide provides an in-depth exploration of CPT codes 25607, 25608, and 25609, along with surgical techniques, recovery protocols, and coding best practices. Look in the CPT index and locate Fracture/Radius/Distal/Open Treatment; the code range is 25607-25609. Period. If the code description does not specify, that imaging may be included, how would I know if it is? One example I am working on is 28750: Arthrodesis, great toe; metatarsophalangeal joint and 28285: Correction, hammertoe (eg, interphalangeal fusion, partial or Feb 11, 2022 · I realize that 76000 is only coded if it is considered a separate procedure as imaging is usually included in the procedure package. *This response is based on the best information available as of 12/19/24. I was going to use 25652. Methods Our institution’s billing databases were reviewed from 1/2016 through 6/2017 for patients undergoing outpatient distal radius fracture fixation, and stratified by CPT codes (25607 = extraarticular, 25608 = 2-piece intraarticular, 25609 = 3 + piece intraarticular). References to CPT Does CPT 25280 Need a Modifier? When billing for CPT code 25280 (Revise wrist/forearm tendon), it is essential to consider the appropriate use of modifiers to ensure accurate reimbursement and compliance with payer guidelines. How To Use CPT Code 77071 This Content Might Be Outdated - Check in Our Free Code Lookup Tool Medical codes change frequently, and using outdated information can lead to denials. Like, seriously, you cannot What is CPT Code 25609 CPT code 25609 is used to describe the treatment of a fracture in the radius bone that involves three or more fragments. AAPC. Ensure you're working with the most up-to-date version of CPT Code 25608 by opening it in our free code lookup tool. CPT code 25609 is used to describe the treatment of a fracture in the radius bone that involves three or more fragments. Ensure you're working with the most up-to-date version of CPT Code 64721 by opening it in our free code lookup tool. You could be setting yourself up for audit trouble if you ignore the number of fracture fragments in a wrist report. It encompasses both the aspiration (withdrawal of fluid) and injection (introduction of medication or What is CPT Code 25609 CPT code 25609 is used to describe the treatment of a fracture in the radius bone that involves three or more fragments. Review the range of codes to determine the correct code. Using time data and supply costs at a single, large academic health center, we used a time-driven activity-based costing analysis to calculate the total day of surgery costs for ORIF of DRFs for the three current procedural terminology (CPT) codes 25607, 25608, and 25609, representing the spectrum of extra-articular to comminuted intra-articular fractures. 5 cm longitudinal incision along the anterolateral aspect of the distal forearm. , fingers, toes). What is CPT Code 25609 CPT code 25609 is used to describe the treatment of a fracture in the radius bone that involves three or more fragments. Global periods are typically classified into 000-day, 010 HCPCS code C1889 describes an implantable or insertable device that is not otherwise classified. However, a keen eye for detail is crucial. CPT code 25607 is for treating a radial fracture that is extra-articular, meaning the break does not extend into the joint. We included patients with age >65 Rationales: CPT®: This is an open treatment of a distal radius fracture. CPT is trademark of the American Medical Association. I use the 25290 tenotomy code and when I run code check, I do not get any coding edits. We first billed: 25609-LT 25609-RT and they did not like that. For example, CPT 25609 describes “open treatment of distal radial intra-articular fracture or epiphyseal separation, with internal fixation of three or more fragments” and can be used for CPT code 25337 is for the surgical reconstruction of the ulna or radioulnar joint, often performed to restore function and alleviate pain. This code is typically used when a healthcare provider performs an open treatment, which means making an incision to access the fracture site, and may involve the use of internal fixation devices such as plates or screws to Search all medical codes 25609 Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments CPT4 code CPT code 25609 is used to describe the treatment of a fracture in the radius bone that involves three or more fragments. BWC is denying the Once these outliers were removed, to avoid modeling outlier charges, we used 80% of the average charge reported by Medicare in each year in New York across each CPT code used for surgical fixation of distal radius which was $572- to $671 for CPT 25606, $615 to $743 for CPT 25607, $702 to $834 for CPT 25608, and $896 to -$1,060 for CPT 25609. The Current Procedural Terminology (CPT ®) code 20900 as maintained by American Medical Association, is a medical procedural code under the range - General Grafts (or Implants) Procedures on the Musculoskeletal System. The Current Procedural Terminology (CPT ®) code 25608 as maintained by American Medical Association, is a medical procedural code under the range - Fracture and/or Dislocation Procedures on the Forearm and Wrist. Any help is appreciated! Apr 14, 2011 · It is appropriate to report the codes (CPT codes 64400-64520) below in conjunction with an operative anesthesia service when a peripheral nerve block injection for post operative pain management is performed. This code is typically utilized by healthcare providers to document and bill for the surgical repair of complex radial fractures, ensuring accurate reimbursement for the specialized care required to address these multi-fragment injuries. Release of the brachioradialis tendon is part of the reduction and work involved in code 25609, Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments, and is not separately reported" Source: CPT®Assistant November 2012 Volume 22 Issue 11 CPT code 25609 is used to describe the treatment of a fracture in the radius bone that involves three or more fragments. Clinical Specifications Overview OCE v22. Jan 1, 2025 · Code Changed 2025-01-01: Short and Medium Descriptions changed. The Current Procedural Terminology (CPT ®) code 25400 as maintained by American Medical Association, is a medical procedural code under the range - Repair, Revision, and/or Reconstruction Procedures on the Forearm and Wrist. Open or Percutaneous Rx: Distal Radius Fracture Codes Colles fracture, closed (813. 25607 - CPT® Code in category: Fracture and/or Dislocation Procedures on the Forearm and Wrist CPT Code information is available to subscribers and includes the CPT code number, short description, long description, guidelines and more. thank you You are responsible for submission of accurate claims. This is because those codes represent other treatment options for fractures of the distal radius, which include procedures like closed manipulation or open reduction. What is the CPT code for closed reduction? Feb 08, 2022 · What is the CPT code for open reduction internal fixation? Open reduction and internal fixation was designated by the CPT codes 25607, 25608, or 25609 (open treatment of extra- or intra-articular distal radius fracture What is the CPT code for removal of foreign body? Jun 12, 2025 · Current Procedural Terminology (CPT) codes are a uniform set of procedural codes developed by the American Medical Association. Search all medical codes 25600 Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation CPT4 code Name of the Procedure: Links to CPT 25609 Physician Services Current Procedural Terminology (CPT®) codes and Medicare Physician Fee Schedule values for common hand and wrist procedures are indicated below. We would like to show you a description here but the site won’t allow us. Ensure you're working with the most up-to-date version of CPT Code 25290 by opening it in our free code lookup tool. Open treatment of intraarticular distal radial fracture or epiphyseal separation with internal fixation of three or more fragments (25609) Percutaneous fixation ulnar styloid fracture (25651) HCPCS Level II codes are additional codes created and maintained by Centers for Medicare & Medicaid Services (CMS). May 1, 2013 · May 1, 2013 Billing for Fracture Care: Emergency Department vs. Apr 14, 2008 · I looked up this code in Ortho Coding Companion and it states "According to CPT guidelines, cast application or strapping (including removal) is only reported as a replacement procedure or when the cast application or strapping is an initial service performed without a restorative treatment or procedure. Apr 19, 2007 · Hint: Your physician's op report may cause you to select incorrect code When CPT 2007 introduced three new distal radial fracture treatment codes, coders figured their lives would get immeasurably easier. Methods Using time data and supply costs at a single, large academic health center, we used a time-driven activity-based costing analysis to calculate the total day of surgery costs for ORIF of DRFs for the three current procedural terminology (CPT) codes 25607, 25608, and 25609, representing the spectrum of extra-articular to comminuted intra-articular fractures. ” If an ulnar styloid fracture is treated in conjunction with the treatment of a distal radius fracture, the following may be used in conjunction with CPT codes 25606–25609 and/or 20690: CPT 25651: “Percutaneous skeletal fixation of ulnar styloid fracture” or CPT code 25609 is used to describe the treatment of a fracture in the radius bone that involves three or more fragments. Something about too many units. Vignettes are reviewed annually and Aug 19, 2024 · The Current Procedural Terminology (CPT) code range for Fracture and/or Dislocation Procedures on the Forearm and Wrist 25500-25695 is a medical code set maintained by the American Medical Association. Documentation do: For distal radial fractures, the surgeon must document the number of fragments -- as the surgeon documents two fragments in our case study -- so you may choose the proper code. Jan 1, 2025 · CPT® Code 25608 in section: Open treatment of distal radial intra-articular fracture or epiphyseal separationCPT® Vignettes illustrate code use through sample patient examples. 51) Malunion of fracture (733. I'm not sure about the hardware, but I believe it is included in the 25609 code as the internal fixation. How To Use CPT Code 20551 This Content Might Be Outdated - Check in Our Free Code Lookup Tool Medical codes change frequently, and using outdated information can lead to denials. The Current Procedural Terminology (CPT ®) code 25280 as maintained by American Medical Association, is a medical procedural code under the range - Repair, Revision, and/or Reconstruction Procedures on the Forearm and Wrist. How To Use CPT Code 64721 This Content Might Be Outdated - Check in Our Free Code Lookup Tool Medical codes change frequently, and using outdated information can lead to denials. What is CPT code 25609? CPT code 25609 represents a surgical procedure aimed at treating complex fractures of the distal radius, particularly those that involve the joint surface or epiphyseal separation. The Current Procedural Terminology (CPT ®) code 25290 as maintained by American Medical Association, is a medical procedural code under the range - Repair, Revision, and/or Reconstruction Procedures on the Forearm and Wrist. The CPT code set accurately describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among physicians, coders Name CPT Description Code ORIF Distal Radius Fracture Open treatment distal radial extra-articular fracture 25607 Open treatment distal radial intra-articular fracture with fixation of 2 fragments 25608 Open treatment, intra-articular fixation of 3 or more fragments 25609 CRPP distal radius fx Percutaneous skeletal fixation of distal radial fracture 25606 Scaphoid ORIF Open treatment scaphoid Our institution’s billing databases were reviewed from 1/2016 through 6/2017 for patients undergoing outpatient distal radius fracture fixation, and stratified by CPT codes (25607 = extraarticular, 25608 = 2-piece intraarticular, 25609 = 3 or more piece intraarticular). These codes provide a standardized description of medical procedures. CPT code information is copyright by the AMA. 89. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements. The term "open treatment" signifies Feb 11, 2022 · I realize that 76000 is only coded if it is considered a separate procedure as imaging is usually included in the procedure package. CPT code 20680 is for the removal of a support implant, typically used in surgical procedures to extract devices like screws or plates. CPT code 25290 is a medical code used to describe the procedure of incising a tendon in the wrist or forearm. Mar 8, 2024 · The clinical information submitted reflects the services of HCPCS Q4031 were not provided distinct and independent of the services of CPT 29450-RT in consideration of the code pair edit and use of a modifier to bypass the code pair edit would not be considered appropriate in this case. The lack of intra-articular and extra-articular documentation results in claims processing delays. 41) Colles fracture, open (813. This reimbursement policy is intended to ensure that you are reimbursed based on the code or codes that correctly describe the health care services provided. CPT Code 25609 is a medical procedural code for surgically repairing a fracture of the lower radius or a separation of the radius from the joint. They further distinguish the CPT codes 25608 and 25609 by the number of fragments requiring internal fixation. She has a Medicare Advantage plan and it has been IMPOSSIBLE to get this paid. Review description and fee schedules for CPT Code 25609, intended for Surgery, and compare rates across different payers. How To Use CPT Code 25608 This Content Might Be Outdated - Check in Our Free Code Lookup Tool Medical codes change frequently, and using outdated information can lead to denials. All three of the surgeons often do a tentomy of the brachioradialis tendon along with the fracture reduction. Jan 1, 2025 · Every vignette contains a Clinical Example/Typical Patient and a description of Procedure/Intra-service. A HCPCS/CPT code shall be reported only if all services described by the code are performed. Also, a ulnar styloid fracture. If so, do I need a modifier for the code? Can I use the same CPT for the surgery with the code for the intraoperative x-ray or does it require a different CPT code? Thank you! Apr 14, 2008 · I looked up this code in Ortho Coding Companion and it states "According to CPT guidelines, cast application or strapping (including removal) is only reported as a replacement procedure or when the cast application or strapping is an initial service performed without a restorative treatment or procedure. The proposed correct coding modifier indicator (CCMI) of “1” would apply for the CPT code pair 25607, Open treatment of distal radial extra-articular fracture or epiphyseal separation, with Jul 16, 2025 · HCPCS Code C1713 refers to a specialized medical supply or device used in healthcare procedures. Physician/Orthopedic Office The purpose of this article is to clarify claim submission guidelines for "global" fracture care services and provide clarification on submitting claims for split care (between an Emergency Department (ED) physician and another physician, such as an orthopedist) and splinting and cast application CPT 20694: ”Removal, under anesthesia, of external fixation system. Nov 26, 2015 · Watch for: Code 25607 refers to an extra-articular fracture, but 25608-25609 (Open treatment of distal radial intra-articular fracture or epiphyseal separation ) describe intra-articular fractures. Can I bill both of them together, or is there a combination code. In simpler terms, this procedure addresses fractures located in the distal radius, which is the lower segment of the outer bone in the forearm, situated near the wrist. Ensure you're working with the most up-to-date version of CPT Code 77071 by opening it in our free code lookup tool. Findings On the disputed date of service the requestor billed $23,811. This surgical intervention is indicated when fractures occur in both bones, necessitating a comprehensive approach to restore their structural integrity. CPT® coding has been provided for the following procedural groups: Commercial Plans: Outpatient Surgical Procedures – Site of Service: CPT/HCPCS Code List Individual Exchange Plans: UHCProvider. How To Use CPT Code 25652 This Content Might Be Outdated - Check in Our Free Code Lookup Tool Medical codes change frequently, and using outdated information can lead to denials. Search for and lookup ICD 10 Codes, CPT Codes, HCPCS Codes, ICD 9 Codes, medical terms, medical newsletters, medicare documents and more. Common Language Description The procedure described by CPT® Code 25575 refers to the open treatment of fractures involving both the radial and ulnar shafts, which are the two long bones in the forearm. Providers/suppliers shall report the Healthcare Common Procedure Coding System/Current Procedural Terminology (HCPCS/CPT) code that describes the procedure performed to the greatest specificity possible. Explanation: This CPT code 2060 is used for arthrocentesis procedures involving small joints or bursae, such as those in the fingers or toes. Ensure you're working with the most up-to-date version of CPT Code 20551 by opening it in our free code lookup tool. 01/01/2015 annual review 2015 CPT code updates added code 20611 and description change for code 20610. ” This is the most complex code, used for comminuted intra-articular fractures where the surgeon fixes three or more fragments. g. The respondent paid $6,738. Aug 24, 2025 · CPT Code 25609: “Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments. The CPT® Code 25609 refers to the open treatment of a distal radial fracture with internal fixation, typically involving surgical intervention for stabilization. She underwent CPT 25609 on the right and left. 21 CPT Code 25605 Medicare Reimbursement CPT code 25605 is reimbursed by Medicare, but the reimbursement specifics can vary based on several factors. Apr 22, 2016 · Our patient fell and broke both wrists. Is this correct? North Carolina Subscriber Answer: The Correct Coding Initiative (CCI) states that 25605 (Closed treatment of distal radial fracture [e. Apr 8, 2019 · Answer: Yes. Learn the code details, clinical responsibility, tips, forum discussions, and coding alerts from Codify by AAPC. Due to the frequent reporting of imaging, these codes were identified by the CPT Editorial Panel and the RVS Update Committee (RUC) to be revised an