Summary & Overview
CPT 25365: Forearm Osteotomy with Radius and Ulna Excision
CPT code 25365 represents a bilateral forearm corrective osteotomy involving excision of bone from both the radius and ulna to correct angular deformities. This surgical code is relevant to orthopedic surgeons, surgical facilities, and payers because it identifies a specific operative intervention used to address functional and structural forearm abnormalities. Nationally, accurate coding of this procedure supports appropriate surgical claim adjudication, resource allocation in operative settings, and tracking of outcomes related to forearm deformity correction.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and which payers commonly cover claims for this code. The publication provides benchmarks for utilization and reimbursement patterns where available, summarizes relevant billing and coding considerations, and highlights policy or coverage updates that could affect authorization and payment processes. Data not available in the input is noted where applicable, and readers will gain a practical overview useful for clinical coders, billing staff, and policy analysts involved in orthopedic surgical services.
Billing Code Overview
CPT code 25365 describes a surgical procedure in which the provider excises bone segments from both the radius and ulna to correct forearm deformities, such as angular malalignment. This is an orthopedic corrective procedure intended to restore more normal forearm alignment and function.
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Service type: Orthopedic surgical procedure, corrective osteotomy with excision of both radius and ulna segments
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Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or adolescent patient presenting with a symptomatic forearm angular deformity (for example post-traumatic malunion or congenital radial/ulnar bowing) causing pain, limited pronation/supination, or cosmetic concern. Preoperative evaluation includes history, physical exam, and radiographs of the forearm (AP and lateral) demonstrating angular deformity involving the radius and ulna. The clinical workflow includes preoperative planning with measurement of deformity, discussion of risks/benefits, informed consent, perioperative anesthesia evaluation, and scheduling for operative correction. In the operating room under general anesthesia with appropriate positioning and fluoroscopic guidance, the surgeon performs osteotomies and excises wedge-shaped bone segments from both the radius and ulna to correct angular alignment, achieves reduction, and stabilizes the osteotomy sites (often with internal fixation such as plates and/or screws). Postoperative care includes immobilization, pain control, neurovascular checks, radiographic confirmation of alignment, and follow-up for rehabilitation and hardware removal as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral Procedure | Use if procedure is performed on both forearms (rare for 25365 which is unilateral). |