Overview of CPT Code 25645: Closed treatment of distal radius fracture with manipulation
CPT Code 25645 refers to the closed treatment of a distal radius fracture, which involves realigning the fractured bone without surgical incision. This procedure is typically performed when the fracture is stable and can be managed without open surgery.
When CPT Code 25645 is Used?
This code is applicable in various clinical scenarios, including:
- Acute distal radius fractures in adults and children.
- Fractures that are non-displaced or minimally displaced.
- Fractures that can be effectively treated without surgical intervention.
Symptoms Indicating This Procedure
Patients may present with the following symptoms:
- Severe pain in the wrist area.
- Swelling and bruising around the wrist.
- 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.
- Falls or direct trauma to the wrist.
- Osteoporosis or weakened bones.
- Participation in high-risk sports or activities.
- Age-related bone density loss.
Diagnostic Tests Before Procedure
Before proceeding with treatment, the following diagnostic tests may be performed:
- X-rays to confirm the fracture and assess its alignment.
- CT scans for complex fractures or to evaluate joint involvement.
- MRI in cases of suspected soft tissue injury.
Procedure Description
The closed treatment procedure involves several key steps:
- Patient is positioned comfortably, and the affected wrist is exposed.
- Local anesthesia may be administered to minimize discomfort.
- The physician gently manipulates the wrist to realign the fractured bone.
- Once aligned, a splint or cast is applied to immobilize the wrist.
- Post-procedure instructions are provided to the patient.
Preparation for the Procedure
Patients should follow these preparation steps:
- Inform the physician of any allergies or medications being taken.
- Avoid eating or drinking for a specified period before the procedure.
- Arrange for transportation home after the procedure, as mobility may be limited.
Recovery and Aftercare
Post-procedure recovery typically involves:
- Wearing a splint or cast for several weeks as directed.
- Managing pain with prescribed medications.
- Regular follow-up appointments to monitor healing.
- Physical therapy may be recommended to restore function.
Possible Complications
While complications are rare, they can occur and may include:
- Improper healing or malunion of the fracture.
- Infection at the site of manipulation.
- Nerve or blood vessel damage.
- Stiffness or loss of motion in the wrist.
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Post-Procedure Follow-Up
Follow-up care is crucial for optimal recovery:
- Initial follow-up within 1-2 weeks to assess healing.
- Subsequent visits every 4-6 weeks until the fracture is healed.
- Additional imaging may be required to confirm proper alignment.
Alternative Treatments
In some cases, alternative treatments may be considered:
- Observation for non-displaced fractures.
- Physical therapy for rehabilitation.
- Use of a brace instead of a cast for certain fractures.
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 medication instructions carefully.
- Avoid using the affected wrist until cleared by a physician.
Patient Education & Prevention
Educating patients on prevention is key:
- Engage in weight-bearing exercises to strengthen bones.
- Use protective gear during sports activities.
- Maintain a healthy diet rich in calcium and vitamin D.
- Consider fall prevention strategies at home.
Billing and Coding Information
CPT Code: 25645
Category: Surgery
Common Modifiers:
- 50 - Bilateral procedure
- RT - Right side
- LT - Left side
Average Cost and Insurance Coverage
Costs can vary based on location and insurance:
- Average cost ranges from $1,500 to $3,000.
- Most insurance plans cover the procedure, but co-pays may apply.
- Check with your insurance provider for specific coverage details.
Related CPT Codes
- 10000 - Incision and drainage of a cyst
Frequently Asked Questions (FAQs)
What is a distal radius fracture?
A distal radius fracture is a break in the radius bone near the wrist.
How long does recovery take?
Recovery typically takes 6 to 8 weeks, depending on the severity of the fracture.
Will I need physical therapy?
Physical therapy may be recommended to regain strength and mobility.
