How To Use CPT Code 26140

CPT 26140 describes a surgical procedure known as synovectomy and extensor reconstruction of the proximal interphalangeal (IP) joint. This article will provide a comprehensive overview of CPT code 26140, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26140?

CPT 26140 is a code used to describe a surgical procedure called synovectomy and extensor reconstruction of the proximal interphalangeal (IP) joint. This procedure involves the removal of the synovial membrane covering the IP joint and the reconstruction of the extensor tendons. It is commonly performed to treat patients with rheumatoid arthritis or other conditions affecting the IP joint. It is important to note that this code applies to a procedure performed on a single IP joint.

2. Official Description

The official description of CPT code 26140 is: ‘Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision over the proximal IP joint, which is the joint farther from the tip of the finger.
3. The provider then divides the soft tissues and reaches the joint.
4. Next, the provider enters the joint capsule and removes the synovial membrane covering the joint.
5. The provider proceeds to perform reconstruction and repair of the extensor tendons, which allow the finger to straighten.
6. Finally, the provider closes the incision with sutures.

4. Qualifying circumstances

CPT 26140 is typically performed on patients with rheumatoid arthritis or other conditions affecting the proximal IP joint. The procedure is intended to alleviate symptoms and improve joint function. It is important to note that this code applies to a procedure performed on a single IP joint.

5. When to use CPT code 26140

CPT code 26140 should be used when a synovectomy and extensor reconstruction procedure is performed on a single proximal IP joint. It is important to accurately document the specific joint on which the procedure was performed to ensure proper coding and billing.

6. Documentation requirements

To support a claim for CPT code 26140, the following documentation is typically required:

• Patient’s diagnosis and the need for synovectomy and extensor reconstruction
• Specific IP joint on which the procedure was performed
• Date of the procedure
• Details of the procedure, including the incision, removal of the synovial membrane, and reconstruction of the extensor tendons
• Any additional relevant information, such as complications or additional procedures performed
• Signature of the provider who performed the procedure

7. Billing guidelines

When billing for CPT code 26140, it is important to ensure that the procedure was performed on a single proximal IP joint. This code should not be reported for procedures performed on other joints or for multiple IP joints. It is also important to follow any specific billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT code 26140 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 with rheumatoid arthritis undergoes synovectomy and extensor reconstruction of the proximal IP joint in their index finger.
2. A provider performs synovectomy and extensor reconstruction of the proximal IP joint in a patient with a traumatic injury to their middle finger.
3. A patient with a chronic inflammatory condition undergoes synovectomy and extensor reconstruction of the proximal IP joint in their ring finger.
4. A provider performs synovectomy and extensor reconstruction of the proximal IP joint in a patient with osteoarthritis affecting their little finger.
5. A patient with a history of joint deformity undergoes synovectomy and extensor reconstruction of the proximal IP joint in their thumb.
6. A provider performs synovectomy and extensor reconstruction of the proximal IP joint in a patient with psoriatic arthritis affecting their index finger.
7. A patient with a history of joint stiffness undergoes synovectomy and extensor reconstruction of the proximal IP joint in their middle finger.
8. A provider performs synovectomy and extensor reconstruction of the proximal IP joint in a patient with a chronic inflammatory condition affecting their ring finger.
9. A patient with a traumatic injury undergoes synovectomy and extensor reconstruction of the proximal IP joint in their little finger.
10. A provider performs synovectomy and extensor reconstruction of the proximal IP joint in a patient with osteoarthritis affecting their thumb.