How To Use CPT Code 26035

CPT 26035 describes the decompression of fingers and/or hand following an injection injury, typically caused by the injection of fluid while operating pressurized hydraulic equipment. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26035?

CPT 26035 is used to describe the decompression of fingers and/or hand following an injection injury. This injury occurs when an individual is injected with fluid, such as paint solvents or grease, while operating pressurized hydraulic equipment. The purpose of this procedure is to remove the injected material and damaged tissue, while preserving vital structures in the affected area.

2. Official Description

The official description of CPT code 26035 is: ‘Decompression fingers and/or hand, injection injury (eg, grease gun).’ This code specifically refers to the decompression procedure performed on the fingers and/or hand following an injection injury, such as from a grease gun or other similar equipment.

3. Procedure

1. The provider begins by making an incision in the skin over the entry point of the injection injury.
2. They then retract the ends of the wound and remove all the injected material.
3. The damaged tissue is debrided, ensuring that vital structures are preserved.
4. If there is a spread of the toxic material to nearby areas, the provider may extend the incision and perform lavaging to wash the affected area.
5. Finally, the wound is closed by suturing the soft tissues in layers.

4. Qualifying circumstances

CPT 26035 is used for patients who have sustained an injection injury, typically involving the dominant hand and the index finger, while operating pressurized hydraulic equipment. The injury results in the introduction of toxic material into the finger, leading to a severe inflammatory response and potential damage. This procedure is performed to decompress the affected area and remove the injected material, preserving vital structures.

5. When to use CPT code 26035

CPT code 26035 should be used when a provider performs the decompression procedure on the fingers and/or hand following an injection injury. It is important to ensure that the injury is a result of an injection of fluid while operating pressurized hydraulic equipment. This code should not be used for injuries caused by other means or in other anatomical locations.

6. Documentation requirements

To support a claim for CPT 26035, the provider must document the following information:

• Description of the injection injury and the need for decompression
• Details of the procedure performed, including the incision, removal of injected material, debridement, and any lavaging if applicable
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures or interventions performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 26035, ensure that the procedure meets the criteria for this code, including the decompression of fingers and/or hand following an injection injury. It is important to accurately document the procedure and provide the necessary supporting documentation. Review the specific billing guidelines provided by the payer to ensure compliance with their requirements.

8. Historical information

CPT 26035 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient sustains an injection injury to their index finger while operating a grease gun. The provider performs decompression of the finger to remove the injected material and damaged tissue.
2. An individual experiences an injection injury to their hand from paint solvents while operating pressurized hydraulic equipment. The provider performs decompression of the hand to remove the injected material and preserve vital structures.
3. A patient presents with an injection injury to multiple fingers following exposure to grease. The provider performs decompression of the affected fingers to remove the injected material and ensure proper healing.
4. An individual sustains an injection injury to their dominant hand while operating machinery. The provider performs decompression of the hand to remove the injected material and prevent further damage.
5. A patient experiences an injection injury to their finger from a hydraulic fluid leak. The provider performs decompression of the finger to remove the injected material and promote healing.
6. An individual sustains an injection injury to their hand while working with paint solvents. The provider performs decompression of the hand to remove the injected material and prevent complications.
7. A patient presents with an injection injury to their fingers caused by a grease gun. The provider performs decompression of the affected fingers to remove the injected material and alleviate symptoms.
8. An individual experiences an injection injury to their hand while operating pressurized hydraulic equipment. The provider performs decompression of the hand to remove the injected material and restore function.
9. A patient sustains an injection injury to their finger from paint solvents. The provider performs decompression of the finger to remove the injected material and prevent infection.
10. An individual experiences an injection injury to their hand while working with grease. The provider performs decompression of the hand to remove the injected material and promote healing.