Summary & Overview
CPT 25375: Forearm Osteotomy of Radius and Ulna with Intramedullary Rods
CPT code 25375 represents a corrective orthopedic procedure — multi-level osteotomy of the radius and ulna with intramedullary rod fixation — used to straighten improperly developed forearm bone shafts. This procedure is clinically significant for pediatric and adult patients with congenital or acquired deformities that impair function or cause pain, and it carries implications for operative planning, device use, and post‑operative rehabilitation at a national level.
Key payers reviewed in national coverage contexts include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise presentation of what the code represents, typical sites of service, and the clinical setting in which it is used. The publication outlines benchmark considerations, common billing modifiers and practice patterns associated with complex orthopedic reconstruction, and policy or coverage elements that commonly affect prior authorization, medical necessity, and claim adjudication for this type of procedure.
The report provides actionable reference material for billing teams, coding specialists, and clinical program managers: clear code definition and scope, payer landscape, and areas where documentation and coding specificity commonly affect reimbursement and compliance. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 25375 describes a surgical corrective osteotomy of the radius and ulna in which the surgeon makes multiple cuts in improperly developed bone shafts and realigns them using intramedullary rods. This procedure is a corrective orthopedic surgery aimed at straightening deformities of the forearm bones.
Service Type: Surgical — Orthopedic corrective osteotomy
Typical Site of Service: Inpatient or outpatient hospital surgical suite or ambulatory surgical center, depending on case complexity and need for postoperative monitoring.
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or adolescent with congenital radial and/or ulnar bowing or malunion of forearm fractures resulting in forearm deformity, limited pronation/supination, pain, or functional impairment. The child presents to orthopedics after failed conservative management (observation, casting, or physical therapy) or persistent deformity following fracture healing. Preoperative evaluation includes history, focused physical exam noting rotational deformity and neurovascular status, and imaging with AP and lateral forearm radiographs and occasionally CT for complex deformity planning. Surgical planning determines multi-level radial and/or ulnar osteotomies with intramedullary fixation (flexible or rigid rods). On the day of surgery, the procedure is performed in an operating room under general anesthesia with fluoroscopic guidance; perioperative antibiotics and appropriate implants are available. Typical postoperative course includes immobilization (splint or cast), pain control, wound checks, radiographic follow-up to assess alignment and healing, and rehabilitation to restore range of motion. This procedure is commonly performed in an ambulatory surgery center or hospital operating room depending on patient age, comorbidities, and complexity of the deformity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT / RT | Left / Right side | Use to identify laterality when only one forearm is operated on. |