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Closed Reduction Thumb Fracture

Hi everyone!

Can anyone help me code for a closed reduction and percutaneous pinning of intra-articular proximal phalanx fracture of the thumb? The two codes I am looking at are 26727 and 26742. I can’t decide which one is right because 26727 specifies proximal phalanx, while 26742 specifies articular. Any suggestions?

Thanks!:)

Medical Billing and Coding Forum

Resection of carpal trapezium w/internal brace stabilization for thumb base arthritis

Hi all,
I would like an expert opinion on which CPT code is most appropriate for what looks like a "suspension version" of a CMC arthroplasty.

Per op report:
"…A marked amount of arthritis at the trapezial
carpometacarpal joint was identified. The trapezium was
osteotomized in 3 places with an osteotome, and the bone was
removed in fragments completely. The wound was irrigated with
antibiotic solution. With a 1.5 mm double-stranded labral tape,
we placed the anchor into the articular base of the second
metacarpal, strung it across the base of the metacarpal, and
then placed a second anchor very snugly with the double
stranded 1.5 mm labral tape into the lateral portion of the
metacarpal base. This suspended the metacarpal and stabilized
it completely, with good positioning and no evident subluxing.
We then irrigated again and placed some antibiotic-soaked
Gelfoam in the space of the trapezium, did a very tight
capsular repair with 3-0 Mersilene sutures, mattresses, and
then closed the skin subcuticular with Monocryl…"

Would this be a 25447 even though no tendon transfers are mentioned as performed?
If 25447 is the most appropriate code, should a -52 be appended?

Thanks,
Aubrey CPC, CRC, COC

Medical Billing and Coding Forum

thumb x-ray coding

I am looking to code a thumb x-ray but I am finding conflicting information. Some resources state that the thumb is considered a finger and should be coded as such. Others state the finger x-ray code is for digits 2-5, excluding the thumb which is part of the hand and should be coded with the hand x-ray CPT.

Can anyone clarify this please?

Thank you

Medical Billing and Coding Forum

thumb x-ray coding

I am looking to code a thumb x-ray but I am finding conflicting information. Some resources state that the thumb is considered a finger and should be coded as such. Others state the finger x-ray code is for digits 2-5, excluding the thumb which is part of the hand and should be coded with the hand x-ray CPT.

Can anyone clarify this please?

Thank you

Medical Billing and Coding Forum

Left Thumb MP Joint Volar Plate Tightening

Need help with CPT procedure code. Left Basilar Joint Arthroplasty–Left Trigger Thumb Release–Left Thumb MP Joint Volar Plate Tightening Any help would be appreciated.
Op Report: A 5-cm incision was made over the dorsum of the metacarpal over the first extensor compartment. Skin flaps were elevated, protecting the cutaneous structures. The joint capsule was then opened sharply. The trapezium was dissected circumferentially, removed piecemeal with a rongeur. A slip of the APL tendon was then released proximally & maintained distally & brought into wound. This was sutured to the FCR tendon. The rest was placed within the space as well as Gelfoam. The joint capsule was then closed with a 3-0 Monocryl suture.

Attention was then directed to the volar thumb. A hockey stick incision was made directly over the thumb pulley system. Skin flaps were elevated. The pulley system was then opened completely under direct visualization. The flexor tendon was then retracted. A couple of horizontal mattress sutures were placed in the volar plate to tighten it & prevent hyperextension. The tourniquet was let down. Both wounds irrigated & hemostasis achieved & closed with Monocryl suture. Sterile dressings & a splint was applied.

Need help with CPT code for this procedure–should use unlisted or would it be appropriate to use 26516 or 26548. Just not sure what to do with this.

Medical Billing and Coding Forum