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Orthopedic Coding Alert

Reader Questions:

Apply 1 Code for These 2 Fractures

Question: A pediatric patient presented with radius and ulna shaft fractures of the left arm. The patient had displaced her radius, but not her ulna. Using conscious sedation, the surgeon reduced the radius with manipulation, then casted the arm (both fractures). Should we report 25565, even though the surgeon didn't manipulate the ulna? Or can we report both 25500 and 25530 to represent the two fractures that the surgeon treated?

New Hampshire Subscriber

Answer: You should report 25565 (Closed treatment of radial and ulnar shaft fractures; with manipulation) if the surgeon used a closed procedure to reduce the
patient's fractures.

Because 25565 appropriately describes the closed reduction, you should not report the combination of 25500 (Closed treatment of radial shaft fracture; without manipulation) and 25530 (Closed treatment of ulnar shaft fracture; without manipulation) to represent the patient's dual fractures.

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