How To Use CPT Code 26236

CPT 26236 describes a partial excision procedure performed on the distal phalanx of the finger. 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 26236?

CPT 26236 is a code used to describe a partial excision procedure performed on the distal phalanx of the finger. This procedure involves the removal of a portion of the bone using techniques such as craterization, saucerization, or diaphysectomy. It is typically performed to address infections or other conditions affecting the distal phalanx.

2. Official Description

The official description of CPT code 26236 is: ‘Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The provider makes an incision in the skin over the distal phalanx of the finger.
3. The provider dissects down through the subcutaneous tissue to expose the affected area of the bone.
4. The periosteum, the outer layer of the bone, is incised and reflected.
5. The provider then removes the infected or affected portion of the bone using techniques such as craterization, saucerization, or diaphysectomy.
6. Hemostasis is achieved at the surgical site, and the wound is closed by suturing the soft tissue layers.

4. Qualifying circumstances

CPT 26236 is typically performed on patients who have infections or other conditions affecting the distal phalanx of the finger. The procedure is performed by a qualified healthcare provider and may involve the use of techniques such as craterization, saucerization, or diaphysectomy to remove the affected portion of the bone.

5. When to use CPT code 26236

CPT code 26236 should be used when a partial excision procedure is performed on the distal phalanx of the finger. It is important to ensure that the procedure is performed on the appropriate bone and that the techniques used align with the description provided in the code.

6. Documentation requirements

To support a claim for CPT code 26236, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the partial excision procedure
• Specific techniques used during the procedure, such as craterization, saucerization, or diaphysectomy
• Date of the procedure
• Details of the procedure, including the incision, dissection, removal of bone, and closure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 26236, it is important to ensure that the procedure performed aligns with the description provided in the code. The appropriate documentation should be included to support the claim. It is also important to follow any specific billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT code 26236 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A surgeon performs a partial excision procedure on the distal phalanx of a patient’s finger to address an infection.
2. A hand specialist uses craterization technique to remove a portion of the distal phalanx of a patient’s finger to treat osteomyelitis.
3. A podiatrist performs saucerization to remove an affected area of the distal phalanx in a patient with a bone tumor.
4. An orthopedic surgeon performs diaphysectomy on the distal phalanx of a patient’s finger to address a non-healing fracture.
5. A plastic surgeon performs a partial excision procedure on the distal phalanx of a patient’s finger to address a chronic bone infection.
6. An orthopedic specialist uses saucerization technique to remove an affected portion of the distal phalanx in a patient with a bone cyst.
7. A hand surgeon performs craterization to remove an infected area of the distal phalanx in a patient with osteomyelitis.
8. A podiatrist performs a partial excision procedure on the distal phalanx of a patient’s toe to address a bone infection.
9. An orthopedic surgeon uses diaphysectomy technique to remove the shaft of the distal phalanx in a patient with a non-union fracture.
10. A plastic surgeon performs saucerization to remove an affected area of the distal phalanx in a patient with a bone tumor.