How To Use CPT Code 26037

CPT 26037 describes a surgical procedure known as decompressive fasciotomy of the hand. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26037?

CPT 26037 is a code used to describe a surgical procedure called decompressive fasciotomy of the hand. This procedure involves cutting through the fascia in the hand to relieve pressure and increase blood flow. It is typically performed to treat conditions such as compartment syndrome of the hand, which is characterized by increased pressure in a muscle compartment leading to muscle and nerve damage and reduced blood flow. Symptoms of compartment syndrome may include decreased sensation, numbness, weakness, and severe pain.

2. Official Description

The official description of CPT code 26037 is: ‘Decompressive fasciotomy, hand (excludes 26035).’ This code specifically excludes decompression of the finger and/or hand following an injection injury, which is covered by CPT code 26035.

3. Procedure

During a decompressive fasciotomy of the hand, the healthcare provider makes an incision in the skin overlying the affected area. They then gain access to the fascia lying above the muscle compartment affected by compartment syndrome. The provider cuts through the fascia and removes any damaged or nonviable tissue, reducing the pressure on the neurovascular structures underneath. This procedure helps restore blood supply and relieve the patient from symptoms. Finally, the provider closes the wound by suturing the soft tissues in layers.

4. Qualifying circumstances

CPT 26037 is typically performed on patients with compartment syndrome of the hand, a condition characterized by increased pressure in a muscle compartment leading to reduced blood flow and potential nerve and muscle damage. The procedure is performed by a healthcare provider to relieve the pressure and restore blood flow. It is important to note that CPT 26037 specifically excludes decompression of the finger and/or hand following an injection injury, which is covered by CPT code 26035.

5. When to use CPT code 26037

CPT code 26037 should be used when a healthcare provider performs a decompressive fasciotomy of the hand to relieve pressure caused by compartment syndrome. It is important to ensure that the procedure is performed on the hand and not the finger, as decompression of the finger is coded differently (CPT code 26035). This code should only be used when the specific circumstances of the procedure match the description provided.

6. Documentation requirements

To support a claim for CPT code 26037, the healthcare provider must document the following information:

• Patient’s diagnosis of compartment syndrome of the hand
• Details of the procedure performed, including the incision, fasciotomy, and closure
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 26037, ensure that the procedure performed matches the description provided. It is important to note that decompression of the finger and/or hand following an injection injury should be coded using CPT code 26035. Additionally, follow any specific billing guidelines provided by the payer or coding guidelines to ensure accurate and appropriate reimbursement.

8. Historical information

CPT code 26037 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. Similar codes to CPT 26037

There are several similar codes to CPT code 26037 within the range of incision procedures on the hand and fingers (26010-26080). These codes may be used for different procedures or variations of decompressive fasciotomy in specific circumstances. It is important to review the code descriptions and guidelines to accurately select the appropriate code for the specific procedure performed.

9. Examples

1. A healthcare provider performs a decompressive fasciotomy of the hand on a patient with compartment syndrome, relieving pressure and restoring blood flow.
2. During a surgical procedure, a surgeon cuts through the fascia in the hand to relieve pressure caused by compartment syndrome, improving the patient’s symptoms.
3. A patient with severe hand pain undergoes a decompressive fasciotomy, which successfully reduces pressure and restores blood flow.
4. A healthcare provider performs a decompressive fasciotomy on a patient with compartment syndrome, alleviating symptoms and preventing further damage.
5. During a surgical procedure, a surgeon cuts through the fascia in the hand to relieve pressure and improve blood flow in a patient with compartment syndrome.
6. A patient with compartment syndrome undergoes a decompressive fasciotomy, resulting in the relief of symptoms and improved hand function.
7. A healthcare provider performs a decompressive fasciotomy on a patient with severe hand pain, successfully reducing pressure and restoring blood flow.
8. During a surgical procedure, a surgeon cuts through the fascia in the hand to relieve pressure caused by compartment syndrome, improving the patient’s symptoms and preventing further damage.
9. A patient with compartment syndrome undergoes a decompressive fasciotomy, resulting in the relief of symptoms and improved hand function.
10. A healthcare provider performs a decompressive fasciotomy on a patient with severe hand pain, successfully reducing pressure and restoring blood flow.