Overview of CPT Code 25426: Open treatment of distal radius fracture

CPT Code 25426 refers to the open surgical treatment of a fracture in the distal radius, which is the larger of the two bones in the forearm. This procedure is typically performed when a fracture is displaced or unstable, requiring surgical intervention to realign and stabilize the bone.

When CPT Code 25426 is Used?

This code is applicable in various clinical scenarios, including:

Displaced distal radius fractures that cannot be aligned properly through closed reduction.
Fractures with associated instability that may lead to malunion or nonunion if not surgically treated.
Fractures resulting from high-energy trauma, such as falls or accidents.

Symptoms Indicating This Procedure

Patients may present with the following symptoms:

Severe pain in the wrist area.
Swelling and bruising around the fracture site.
Decreased range of motion in the wrist and hand.
Visible deformity or abnormal positioning of the wrist.

Causes and Risk Factors

Understanding the causes and risk factors can help in prevention and management.

Falls, particularly in older adults.
Sports injuries, especially in contact sports.
Osteoporosis, which weakens bones and increases fracture risk.
High-impact accidents, such as motor vehicle collisions.

Diagnostic Tests Before Procedure

Several diagnostic tests may be performed to confirm the fracture and assess its severity:

X-rays to visualize the fracture and determine its type.
CT scans for detailed imaging of complex fractures.
MRI in cases where soft tissue injury is suspected.

Procedure Description

The open treatment of a distal radius fracture involves several key steps:

Administer anesthesia to ensure patient comfort.
Make an incision over the fracture site to access the bone.
Realign the fractured bone fragments into their proper position.
Stabilize the fracture using plates, screws, or pins.
Close the incision with sutures and apply a dressing.

Preparation for the Procedure

Patients should follow these steps to prepare for surgery:

Avoid eating or drinking for at least 8 hours before the procedure.
Discuss any medications with the surgeon, especially blood thinners.
Arrange for transportation to and from the surgical facility.
Wear loose-fitting clothing and remove jewelry before surgery.

Recovery and Aftercare

Post-operative recovery typically involves:

Wearing a splint or cast for several weeks to immobilize the wrist.
Taking prescribed pain medications as needed.
Attending follow-up appointments to monitor healing.
Engaging in physical therapy to regain strength and mobility.

Possible Complications

While complications are rare, they can occur and may include:

Infection at the surgical site.
Nerve or blood vessel damage.
Nonunion or malunion of the fracture.
Stiffness or loss of motion in the wrist.

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Post-Procedure Follow-Up

Follow-up care is crucial for successful recovery:

Initial follow-up within 1-2 weeks post-surgery to check the incision.
Subsequent visits every 4-6 weeks to monitor bone healing.
Physical therapy sessions as recommended by the surgeon.

Alternative Treatments

In some cases, non-surgical options may be considered:

Closed reduction and casting for non-displaced fractures.
Bracing and physical therapy for minor injuries.
Pain management with medications and rest.

Home Care Tips

Patients can follow these tips for effective home care:

Keep the wrist elevated to reduce swelling.
Apply ice packs to the area for pain relief.
Follow the surgeon's instructions regarding activity restrictions.
Monitor for signs of infection, such as increased redness or drainage.

Patient Education & Prevention

Educating patients on prevention can reduce future risks:

Engage in strength training and balance exercises to prevent falls.
Ensure adequate calcium and vitamin D intake for bone health.
Use protective gear during sports and high-risk activities.
Regularly assess home environments for fall hazards.

Billing and Coding Information

CPT Code: 25426

Category: Surgery

Common Modifiers:

Average Cost and Insurance Coverage

Costs can vary based on location and insurance:

Average cost ranges from $5,000 to $15,000 depending on facility and complexity.
Most insurance plans cover the procedure, but co-pays and deductibles may apply.