Summary & Overview
CPT 25565: Closed Treatment of Both-Bone Forearm Shaft Fractures
CPT code 25565 represents the closed treatment (manipulation without incision) of both-bone forearm fractures involving the shafts of the radius and ulna. Nationally, this code captures a common orthopedic procedure used in acute fracture management, with implications for acute care workflows, facility billing, and post-procedure follow-up.
Key payers in typical national coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, payer coverage considerations, and operational benchmarks relevant to this service line. The publication summarizes coding intent, typical sites of service (emergency departments, urgent care, and outpatient orthopedic clinics), and how this code fits into acute musculoskeletal care pathways.
The report provides benchmarking insights where available, outlines common billing modifiers that may apply, and highlights areas where policy updates or payer-specific rules can affect claim adjudication. Clinical context explains when closed manipulation is used versus open surgical approaches and the patient settings most likely to encounter this service. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 25565 describes a closed treatment of both-bone forearm fractures involving the shafts of the radius and ulna. The provider manipulates the fractures into alignment without making an incision.
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Service type: Closed manipulation of both-bone forearm fractures
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Typical site of service: Emergency department, urgent care, or outpatient surgical/orthopedic clinic where closed fracture management is performed
Clinical & Coding Specifications
Clinical Context
A 32-year-old adult presents to the emergency department after a fall onto an outstretched hand with acute forearm pain, visible deformity, swelling, and limited wrist and elbow motion. Radiographs confirm displaced transverse fractures of the radial and ulnar shafts without open skin disruption. The orthopedic surgeon performs a closed reduction of both-bone forearm fractures under regional block or conscious sedation in the operating room or procedure suite. The provider manipulates the radius and ulna into anatomic alignment without making an incision and applies a long-arm cast or splint for immobilization. Post-reduction radiographs confirm acceptable alignment. Follow-up visits occur in the orthopedic clinic for cast checks and repeat imaging to monitor healing and range-of-motion rehabilitation as tolerated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable E/M service by the same physician on the same day of procedure | Use when a documented distinct evaluation and management visit occurs immediately before the closed reduction. |
50 | Bilateral procedure | Use if closed reduction is performed on both left and right forearms (rare for this code). |