Summary & Overview
CPT 25450: Implantation for Distal Radius/Ulna Growth Modulation
CPT code 25450 covers the surgical implantation of screws or specialized staples into the distal radial or ulnar epiphysis to temporarily halt growth in that bone. This growth modulation technique is significant nationally as a limb- and joint-preserving intervention used in pediatric and adolescent patients to correct or prevent progressive angular deformities and limb-length discrepancies around the wrist. The code captures a focused orthopedic surgical service with implications for device utilization, perioperative management, and post‑procedural follow-up.
Key payers discussed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context, typical sites of service, and commonly reported billing modifiers. The publication provides benchmarks on utilization and payment where available, summarizes relevant coding and coverage considerations, and outlines the clinical rationale for temporary epiphyseal growth inhibition. The material is intended to inform coding professionals, hospital billing teams, and orthopedic clinicians about the procedural definition, typical care setting, and areas where payers often focus their coverage reviews. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 25450 describes the surgical implantation of screws or specialized staples into the epiphyseal (growth plate) region of the distal radius or ulna near the wrist to produce temporary growth inhibition of that bone. This procedure is performed to modulate longitudinal bone growth for clinical indications related to wrist and forearm deformity correction.
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Service type: Surgical, growth modulation/epiphysiodesis
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Typical site of service: Hospital operating room or ambulatory surgical center, with postoperative care in the same facility or clinic setting
Clinical & Coding Specifications
Clinical Context
A typical patient is a skeletally immature child or adolescent who presents with a distal radial or ulnar growth disturbance producing progressive angular deformity, limb-length discrepancy at the wrist, or symptomatic physeal (growth plate) imbalance. Common clinical presentation includes wrist pain, visible radial/ulnar deviation, and functional limitation after prior fracture, congenital growth arrest, or overgrowth of one forearm bone. Evaluation includes history, physical exam, and radiographs of the wrist and forearm showing asymmetric physeal activity and progressive deformity. Growth modulation with temporary hemiepiphysiodesis (implantation of screws or specialized staples into the distal radius or ulna) is scheduled when further growth is expected and the deformity is correctable by guided growth. The workflow: preoperative planning with standing and comparative radiographs, informed consent, perioperative anesthesia evaluation, sterile operative implantation of the device under fluoroscopic guidance, postoperative radiographs to confirm implant position, routine wound checks, and interval radiographic follow-up until desired correction is achieved and implants are removed when appropriate. Typical site of service is an outpatient ambulatory surgical center or hospital outpatient department; some younger patients may require brief inpatient observation for anesthesia or pain control.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing separately for the surgeon's professional interpretation or component if technical component billed by facility |