Victoria Posted Fri 05th of July, 2019 12:10:11 PM
What is the CPT code for Closed Reduction and Percutaneous fixation of radial shaft fracture? Doctor previously did and I&D and ORIF of the BBFA but the fixation failed and the fracture angulated.
SuperCoder Answered Mon 08th of July, 2019 05:45:23 AM
There is no specific defined CPT code for Closed Reduction and Percutaneous Fixation of Radial Shaft Fracture. It is suggested to use the CPT code 25999 (Unlisted procedure, forearm or wrist) for this procedure.
Since, your doctor has performed I&D and ORIF previously, append appropriate modifier if the patient is under global period.
Make sure when reporting a procedure with an unlisted code, submit a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. Also include the operative notes or other relevant documentation to strengthen the claim and to avoid a possible denial. Your payers will consider claims with unlisted procedure codes on a case by case basis, and they will determine payment based on the documentation you provide.
Hope this helps!