Summary & Overview
CPT 25624: Closed Manipulation of Scaphoid Fracture
CPT code 25624 denotes closed manipulation for a scaphoid (wrist) fracture and captures non‑operative management of a common carpal bone injury often caused by a fall on an outstretched hand. Nationally, this code matters because scaphoid fractures are frequent in active populations and their management influences downstream imaging, immobilization, and follow‑up care costs. Proper coding distinguishes closed manipulation from open surgical fixation and affects coverage, billing audits, and clinical pathways.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for scaphoid closed manipulation, payer coverage considerations, typical sites of service, and benchmarking themes such as utilization drivers and coding differentiation from operative care. The publication also outlines pertinent policy or coding update summaries where available and highlights operational implications for revenue cycle and documentation.
This executive summary serves clinicians, coders, and policy analysts seeking a national perspective on how CPT code 25624 fits into care delivery for wrist fractures, what to expect from major payers, and which clinical and administrative factors most affect claim processing and denials.
Billing Code Overview
CPT code 25624 describes a closed treatment of a scaphoid fracture by manipulation only. The procedure addresses a fracture of the scaphoid, one of the carpal bones in the wrist, typically resulting from extending the hand to break a fall. The provider performs manual manipulation without making any incision.
Service Type: Fracture management — closed manipulation
Typical Site of Service: Outpatient clinic, emergency department, or ambulatory surgical center (non‑operative, procedure performed without incision)
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents to the emergency department after falling onto an outstretched hand while playing basketball. He reports focal radial-sided wrist pain, tenderness in the anatomical snuffbox, and pain with wrist extension and gripping. Initial wrist radiographs are obtained and demonstrate a nondisplaced fracture of the scaphoid. The emergency physician or orthopedic hand specialist performs a closed reduction and manipulation of the scaphoid without any incision and applies a short-arm thumb spica cast or splint. The clinical workflow includes triage and history/physical, diagnostic imaging (radiographs ± repeat views), informed consent for closed treatment, procedural sedation or local/regional anesthesia as needed, 25624 closed treatment (manipulation) of scaphoid fracture, post-reduction radiographic confirmation, cast application, and discharge with follow-up arranged in hand clinic for re-imaging and possible operative management if displacement or nonunion develops.
Coding Specifications
- For
25624(closed treatment of scaphoid fracture using manipulation only), the most clinically relevant modifiers and their use are summarized below.
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side |