# cpt 25606 for closed reduction?



## BFAITHFUL (Nov 22, 2011)

I'm not sure what code to use for the following im thinking CPT 25606, & 20690


DX:  Comminuted intra-articular displaced fracture of right distal radius and osteoporosis.
Procedure: Closed reduction, application of an AO external fixator under fluoroscopic control of right wrist.

The fracture was reduced with traction, dorsal flexion, then volar flexion and ulnar deviation and pressing on the distal fragment.  The fratgments fell into alignment; therefore, an open reduction was not required.  The finger traps were removed.  Patient was prepped and draped in usual manner.  An esmarch bandage was used to exsanguinate blood from the hand at the second metacarpal measuring the AO guide for the Schanz pins; 2.5 pins were utilized.  An incision was made.  Blunt dissection was made to the second diaphysis of the metarcarpal with a periosteal elevator and at a 45 degreee angle, a drill hole was made.  One schanz pin was advanced just until it went through the second cortex as well as the distal.  Once this accomplished the guide was removed.  an incision was made about 3cm proximal to the fracture making a long enough incision to dissect the branch of the radial nerve and retract it volarly.  a periosteal elevator was used down to bone and the guide was then placed.  The drill bit was used and two schanz pins were inserted until the tips reached the outer cortex.  Once this was accomplished,k the measurement was made for the carbon bar.  the clamps were placed on the pins and tightened; however, allowing motion to the rod and for distraction.    Onced this was accomplished, the traction was placed.  the proximal screw was tightened to hold the carbon rod.  the fracture was reduced again.  one it was close to anatomical reduction, shockingly with the amount of comminution and displacement, it was elected no other fixation was necessary.  All the screws were tightened to prevent any motion.  


Thanks!!!


----------



## BFAITHFUL (Nov 22, 2011)

any takers on this one please?


----------



## orthobiller2000 (Nov 22, 2011)

*Billing Manager*

I think I would be going with 25605 and 20690......


----------



## maryanneheath (Nov 22, 2011)

I agree with 25605 and 20690....


----------



## BFAITHFUL (Nov 23, 2011)

thanks


----------

