Summary & Overview
CPT 25393: Forearm Osteotomy with Bone Graft Lengthening
CPT code 25393 represents an orthopedic surgical procedure in which both the radius and ulna are osteotomized and autologous bone grafts are applied to increase the length of each bone. This reconstructive forearm operation is used in clinical situations requiring forearm lengthening or correction of bone deficiency and has implications for surgical resource needs, anesthesia, and postoperative care across facilities nationally. The code captures a complex operative service that typically occurs in hospital operating rooms or ambulatory surgical centers.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise view of clinical context, expected sites of service, and the administrative framing of the procedure for payers and billing teams. Readers will find benchmarking context where available, explanations of the procedure’s clinical scope, common billing modifiers provided in the input, and guidance on where to locate ICD-10 diagnosis mapping and related codes. Data not available in the input is noted where applicable.
This national summary is intended for healthcare administrators, coding professionals, and policy analysts seeking a clear description of the service represented by CPT code 25393, how it is typically delivered, and which major payers are commonly involved.
Billing Code Overview
CPT code 25393 describes a surgical procedure in which the surgeon performs osteotomy of both the radius and ulna and augments length by affixing autologous bone grafts to each bone. This procedure is a form of limb-lengthening or reconstructive forearm surgery performed to increase bone length in the forearm.
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Service type: Surgical, orthopedic reconstructive procedure involving osteotomy and bone grafting
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Typical site of service: Hospital operating room or ambulatory surgical center, based on the need for general or regional anesthesia and intraoperative orthopedic care
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adolescent or adult with congenital radial clubhand, post-traumatic forearm shortening with nonunion, or growth arrest leading to significant shortening of the radius and ulna causing functional impairment. The patient presents with reduced forearm length, wrist instability, limited range of motion, and difficulty with daily activities. Preoperative workup includes history and physical, radiographs of the forearm and wrist, CT or MRI if needed, and assessment for autologous bone graft sites (commonly iliac crest). The operative team is usually an orthopedic surgeon with hand/upper-extremity specialization. Intraoperatively, the surgeon performs osteotomies of the radius and ulna, harvests autologous bone grafts, places grafts to increase bone length, and stabilizes the bones with internal fixation (plates, intramedullary devices) or external fixation as indicated. Postoperative care includes immobilization, pain control, wound care, physical therapy for range of motion and strength, and radiographic surveillance for graft incorporation and union. Follow-up visits typically occur at 2 weeks, 6 weeks, 3 months, and until radiographic union is achieved.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or complexity substantially exceeds usual for the procedure (document rationale). |