Overview of CPT Code 25455: Open treatment of distal radius fracture

CPT Code 25455 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 restore proper alignment and function.

When CPT Code 25455 is Used?

This code is applicable in various clinical scenarios, including:

Displaced distal radius fractures that cannot be aligned properly with non-surgical methods.
Fractures associated with significant wrist instability.
Fractures that have not healed properly with conservative treatment.
Fractures in patients with high functional demands requiring precise anatomical restoration.

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.
Visible deformity or abnormal positioning of the wrist.

Causes and Risk Factors

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

Traumatic injuries from falls or accidents.
Sports-related injuries.
Osteoporosis, which weakens bones and increases fracture risk.
Age-related bone density loss, particularly in older adults.

Diagnostic Tests Before Procedure

Several diagnostic tests may be performed to confirm the need for surgery:

X-rays to visualize the fracture and assess its alignment.
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 to restore normal anatomy.
Use plates, screws, or pins to stabilize the fracture.
Close the incision with sutures and apply a dressing.

Preparation for the Procedure

Patients should follow these steps to prepare for surgery:

Discuss any medications with the surgeon, especially blood thinners.
Avoid eating or drinking for a specified period before surgery.
Arrange for transportation to and from the surgical facility.
Wear loose-fitting clothing on the day of the procedure.

Recovery and Aftercare

Post-operative recovery typically involves:

A recovery period of 6 to 12 weeks, depending on the fracture severity.
Regular follow-up appointments to monitor healing.
Wound care instructions to prevent infection.
Pain management with prescribed medications.

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 to 2 weeks post-surgery.
Subsequent visits every 4 to 6 weeks to assess healing.
Physical therapy may be recommended to regain strength and mobility.

Alternative Treatments

Non-surgical options may be considered in certain cases:

Casting or splinting for stable fractures.
Physical therapy to improve function and strength.
Pain management with medications and ice therapy.

Home Care Tips

Patients can follow these tips for effective home care:

Keep the surgical area clean and dry.
Follow prescribed medication schedules for pain relief.
Elevate the wrist to reduce swelling.
Engage in gentle exercises as advised by the healthcare provider.

Patient Education & Prevention

Educating patients on prevention is key:

Engage in weight-bearing exercises to strengthen bones.
Ensure adequate calcium and vitamin D intake.
Use protective gear during sports and high-risk activities.
Fall-proof the home environment to reduce injury risk.

Billing and Coding Information

CPT Code: 25455

Category: Surgery

Common Modifiers:

50 - Bilateral procedure
RT - Right side
LT - Left side

Average Cost and Insurance Coverage

Costs can vary based on several factors:

Average cost ranges from $5,000 to $15,000 depending on facility and complexity.
Most insurance plans cover the procedure, but patients should verify with their provider.