Overview of CPT Code 25665: Closed treatment of distal radius fracture with manipulation

Overview of CPT Code 25665: Closed treatment of distal radius fracture with manipulation

CPT Code 25665 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 25665 is Used?

This code is applicable in various clinical scenarios, including:

• Acute distal radius fractures in adults and children.
• Fractures that are not displaced or minimally displaced.
• Fractures that can be 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.
• Inability to move the wrist or hand.
• 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.
• Sports injuries, particularly in contact sports.
• Age-related factors, as older adults are more prone to fractures.

Diagnostic Tests Before Procedure

Before proceeding with treatment, the following diagnostic tests may be performed:

• X-rays to confirm the fracture and assess displacement.
• CT scans for complex fractures or to evaluate joint involvement.
• MRI if soft tissue injury is suspected.

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 cast or splint is applied to immobilize the wrist.
• Post-procedure instructions are provided to the patient.

Preparation for the Procedure

Patients should follow these steps to prepare for the procedure:

• Inform the physician of any allergies or medications being taken.
• Avoid eating or drinking for a few hours before the procedure if sedation is planned.
• Wear loose-fitting clothing for comfort during the procedure.

Recovery and Aftercare

Post-procedure care is crucial for recovery:

• Rest the wrist and avoid using it for several weeks.
• Keep the cast dry and clean; follow care instructions provided.
• Take prescribed pain medications as needed.
• Attend follow-up appointments for monitoring and cast adjustments.

Possible Complications

While complications are rare, they can occur:

• 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

Regular follow-up is essential for optimal recovery:

• Initial follow-up within 1-2 weeks to check alignment and cast fit.
• Subsequent visits every 4-6 weeks to monitor healing.
• Physical therapy may be recommended after cast removal.

Alternative Treatments

In some cases, alternative treatments may be considered:

• Observation for non-displaced fractures.
• Physical therapy for rehabilitation.
• Use of splints instead of casts for certain fractures.

Home Care Tips

Patients can follow these tips for better home care:

• Keep the wrist elevated to reduce swelling.
• Apply ice packs to the area for pain relief.
• Avoid activities that may stress the wrist during recovery.

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.

Billing and Coding Information

CPT Code: 25665

Category: Surgical Procedures

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