Overview of CPT Code 25535: Open treatment of distal radius fracture
CPT Code 25535 refers to the open treatment of a fracture of 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 25535 is Used?
This procedure is indicated in several clinical scenarios.
- Displaced distal radius fracture requiring surgical intervention.
- Fractures that cannot be adequately aligned through closed reduction.
- Fractures associated with significant soft tissue injury.
- Fractures in patients with underlying conditions that impair healing.
Symptoms Indicating This Procedure
Patients may present with various symptoms that suggest the need for surgical treatment.
- Severe pain in the wrist or forearm.
- Swelling and bruising around the fracture site.
- Deformity or abnormal positioning of the wrist.
- Inability to move the wrist or fingers.
Causes and Risk Factors
Understanding the causes and risk factors can help in prevention and management.
- Trauma from falls, sports injuries, or accidents.
- Osteoporosis, which weakens bones and increases fracture risk.
- Age-related bone density loss.
- Certain medical conditions that affect bone health.
Diagnostic Tests Before Procedure
Several diagnostic tests are essential for confirming the need for surgery.
- X-rays to visualize the fracture and assess displacement.
- CT scans for detailed imaging of complex fractures.
- MRI in cases of suspected soft tissue injury.
Procedure Description
The open treatment procedure 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 or staples.
Preparation for the Procedure
Proper preparation is crucial for a successful outcome.
- Avoid eating or drinking for several hours before surgery.
- Discuss any medications with your doctor, especially blood thinners.
- Arrange for transportation to and from the surgical facility.
- Wear loose, comfortable clothing on the day of the procedure.
Recovery and Aftercare
Post-operative care is vital for healing.
- Expected recovery period is typically 6 to 12 weeks.
- Keep the surgical site clean and dry.
- Follow prescribed pain management and anti-inflammatory medications.
- Attend follow-up appointments for monitoring healing.
Possible Complications
While complications are rare, they can occur.
- 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
Regular follow-up is essential for assessing recovery.
- Initial follow-up within 1-2 weeks post-surgery.
- Subsequent visits every 4-6 weeks to monitor healing.
- Physical therapy may be recommended to regain strength and mobility.
Alternative Treatments
Non-surgical options may be considered in certain cases.
- Closed reduction and immobilization with a cast.
- Physical therapy for minor fractures.
- Pain management with medications and rest.
Home Care Tips
Patients can take steps to aid their recovery at home.
- Keep the wrist elevated to reduce swelling.
- Apply ice packs to the area as needed.
- Follow a balanced diet to support healing.
- Avoid strenuous activities until cleared by your doctor.
Patient Education & Prevention
Education is key to preventing future fractures.
- Engage in weight-bearing exercises to strengthen bones.
- Ensure adequate calcium and vitamin D intake.
- Use protective gear during sports and high-risk activities.
- Regular check-ups for bone health, especially in older adults.
Billing and Coding Information
CPT Code: 25535
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.
- Insurance typically covers surgical procedures, but co-pays may apply.
- Check with your insurance provider for specific coverage details.
Related CPT Codes
Frequently Asked Questions (FAQs)
What is a distal radius fracture?
A distal radius fracture is a break in the larger bone of the forearm near the wrist.
How long does recovery take?
Recovery typically takes 6 to 12 weeks, depending on the severity of the fracture.
Will I need physical therapy?
Physical therapy may be recommended to help regain strength and mobility after surgery.
What are the signs of infection?
Signs of infection include increased redness, swelling, warmth, and discharge from the surgical site.
