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Cpt code scapholunate ligament tear repair how to#
Cpt code scapholunate ligament tear repair free#

Multiple procedure modifier 51 would be used with code 26418 because it has a lower relative value than 24305. Because there is no NCCI edit between codes 2438, it is not necessary to use modifier 59 for this code combination. The operative note must contain clinical justification and clear documentation of techniques, such as z-lengthening of the flexor pronator mass or lengthening of the flexor pronator fascia, in addition to dissection of the muscle and/or fascia, placement of the ulnar nerve in a submuscular location, and resuturing of the muscle.

If the physician performs tendon lengthening as a component of the submuscular transposition, a secondary CPT code may be reportable: 24305, Tendon lengthening, upper arm or elbow, each tendon. Instead, surgeons may perform a submuscular transposition, which also is reportable as 64718. This code is used commonly to report simple decompression of the ulnar nerve, such as anterior transposition or subcutaneous transposition. Insufficient documentation to support tendon lengthening in conjunction with submuscular transposition of the ulnar nerveĬPT code 64718 is used to describe Transposition and/or neuroplasty of the ulnar nerve at the elbow.If a second carpal bone is fully or partially excised, use of CPT code 25210 also is supported, but the code must be appended with modifier 59 to explain that the provider is not using it to report the first carpectomy, thus unbundling the arthroplasty service. Removal of the trapezium or trapezoid is included in CPT code 25447. Multiple procedure modifier 51 would be used with code 26480 because it has a lower relative value than 25447. Because there is no National Correct Coding Initiative (NCCI) edit between codes 2540, it is not necessary to use modifier 59 for this code combination.

Cpt code scapholunate ligament tear repair free#

When a flexor carpi radialis tendon graft is harvested in the forearm for arthroplasty stabilization, the American Society of Surgery for the Hand (ASSH) has instructed its members to utilize code 26480 for reporting Transfer or transplant of tendon, carpometacarpal area or dorsum of hand without free graft, each tendon based upon directives published in “CPT Assistant.” This code represents the location of the tendon placement, not the location of harvesting. Whether excisional arthroplasty is performed with an interposition tendon graft, tendon suspension, or allograft tightrope, all methods are reported with CPT code 25447, Arthroplasty, interposition, intercarpal or carpometacarpal joint.

Hand surgeons use a range of techniques for first carpometacarpal (CMC) excisional arthroplasty.

Incorrect reporting of first CMC excisional arthroplasty and associated services.

Be consistent when creating the operative note procedure list and documenting operative detail within the note body. If intra-articular, the operative note must specify the number of fragments (one to two or three or more). An example is distal radius fractures, which require documentation of whether the fracture is extra- or intra-articular. Location specificity also is essential in fracture management reporting. In particular, zone 2 flexor tendon repairs in the hand are important, as a separate CPT code is used to describe such procedures. Codes are selected based on the location of the repair, not the site of tendon insertion.

Lack of specificity in documentation of tendon repair and fracture managementĬurrent Procedural Terminology (CPT) includes references to specific locations in the forearm, wrist, hand, and fingers for reporting flexor and extensor tendon repair codes.

Cpt code scapholunate ligament tear repair how to#

Here, we highlight eight frequently encountered errors when coding hand procedures and how to fix them. Billing for hand procedures is among the most complex types of orthopaedic coding.