Summary & Overview

CPT 25560: Closed Treatment of Both-Bone Forearm Shaft Fracture

CPT code 25560 denotes closed treatment of both-bone forearm fractures involving the shafts of the radius and ulna without incision or manipulation. This code captures a specific nonoperative management service relevant to acute orthopedic care, fracture clinics, and emergency settings. Nationally, proper coding of closed forearm fracture treatment affects clinical documentation, procedure mix reporting, and claims processing for trauma and orthopedic practices.

Key payers considered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The review outlines how payers commonly classify and adjudicate nonoperative forearm fracture services, and highlights where policies or coverage rules can influence authorization and bundling.

Readers will gain a concise clinical and billing context for 25560, including expected service settings, common modifiers encountered in practice (listed separately), and areas where documentation drives appropriate use of the code. The publication also summarizes benchmark considerations, typical reimbursement contexts, and policy updates that affect national billing practices. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare25560CPTforearm fractureclosed treatmentorthopedicsemergency careprocedure coding

Billing Code Overview

CPT code 25560 describes treatment of a both-bone forearm fracture involving the shafts of the radius and ulna using a closed procedure. The provider does not make an incision and does not perform manipulation of the fractures during the service.

Service type: Closed treatment of both-bone forearm shaft fractures
Typical site of service: Emergency department, urgent care, or outpatient orthopedic clinic depending on presentation and facility capabilities

Clinical & Coding Specifications

Clinical Context

A 32-year-old adult presents to the emergency department after a fall onto an outstretched hand. Initial radiographs demonstrate a closed both-bone forearm fracture involving the mid-shafts of the radius and ulna without neurovascular compromise or open wound. The orthopedic provider performs a closed treatment consisting of immobilization with a well-molded long-arm cast after confirming acceptable alignment on fluoroscopic imaging. No incision is made and no closed manipulation (no closed reduction) is attempted because alignment is acceptable and the patient is stable. Typical workflow includes initial ED assessment, imaging (plain radiographs, possible fluoroscopy), orthopedic consultation, placement of immobilization (long-arm cast or splint), post-procedure radiographs to document alignment, and discharge with sling, cast care instructions, and follow-up arranged in an orthopedic clinic within 1–2 weeks for re-evaluation and repeat imaging.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of a procedure	Use when an E/M visit is performed and documented separately from the cast application procedure on the same day.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally intended (e.g., limited immobilization performed).
`53`	Discontinued procedure	Use if the immobilization procedure was started but aborted due to an intra-procedural complication.
`57`	Data not available in the input.	Data not available in the input.
`59`	Distinct procedural service	Use to indicate a distinct service when billing other procedures on the same day that are not normally reported together.
`76`	Repeat procedure by same physician	Use when the immobilization procedure is repeated later the same day by the same provider.
`77`	Repeat procedure by another physician	Use when another physician repeats the immobilization procedure the same day.
`LT`	Left side	Use to indicate the procedure was performed on the left forearm.
`RT`	Right side	Use to indicate the procedure was performed on the right forearm.
`AS`	Ambulatory surgery center (payment modifier)	Use when the service is provided in an ambulatory surgical center setting.
`59`	Distinct procedural service	Use when an unrelated procedure is performed on the same day and needs separation.
`22`	Unusual procedural services	Use when the service required substantially greater work than usual (documented justification).
`76`	Repeat procedure by same physician	Use when service is repeated by the same physician during the postoperative period.
`52`	Reduced services	Use when casting/immobilization is less extensive than typical and properly documented.

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Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
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Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`25600`	Closed treatment of distal radial fracture (e.g., Colles or Smith type) without manipulation	May be performed for distal radius fractures requiring closed management; related when fracture location differs but similar closed technique applies.
`25515`	Closed treatment of humeral shaft fracture without manipulation	Related as another closed, nonoperative long-bone shaft fracture management code performed in the same clinical context for adjacent anatomic regions.
`29075`	Application of short-arm cast	Commonly performed for isolated forearm or wrist fractures when shorter immobilization is appropriate; may be used instead of a long-arm cast depending on fracture pattern.
`20690`	Application of external fixation device (unilateral)	Used when closed management is inadequate and temporary external fixation is required prior to definitive care.
`73630`	Radiologic exam, forearm; complete, minimum of two views	Imaging commonly obtained before and after immobilization; supports documentation of alignment and appropriate coding for imaging services.