How To Use CPT Code 26350

CPT 26350 describes a procedure involving the repair or advancement of a flexor tendon in the hand or finger, specifically in an area other than zone 2. 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 26350?

CPT 26350 is used to describe a procedure in which a healthcare provider repairs or advances a flexor tendon in the hand or finger, excluding zone 2. This code is specifically for cases where a free graft is not used during the repair or advancement process.

2. Official Description

The official description of CPT code 26350 is: ‘Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no man’s land); primary or secondary without free graft, each tendon.’

3. Procedure

1. The healthcare provider begins by preparing and anesthetizing the patient.
2. An incision is made in the skin to access the flexor tendon in the hand or finger.
3. The provider carefully dissects through the tissue until reaching the tendon.
4. The tendon is repaired using sutures or other appropriate means, or it may be advanced by detaching it from its insertion and reattaching it at a more advanced position for improved joint function.
5. Bleeding is checked and the incision is closed.
6. No free graft is used during this repair or advancement procedure.

4. Qualifying circumstances

CPT 26350 is applicable when a flexor tendon repair or advancement is performed in an area other than zone 2 of the digital flexor tendon sheath. This code is used for primary or secondary repairs without the use of a free graft. It is important to note that zone 2, also known as “no man’s land,” extends from the flexor digitorum superficialis (FDS) insertion point in the middle phalanx to the distal palmar crease.

5. When to use CPT code 26350

CPT code 26350 should be used when a healthcare provider performs a repair or advancement of a flexor tendon in the hand or finger, excluding zone 2, without the use of a free graft. This code is appropriate for both primary repairs of acute injuries and secondary repairs of non-acute injuries that require additional tissue for completion.

6. Documentation requirements

To support a claim for CPT 26350, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for flexor tendon repair or advancement
• Specific details of the procedure, including the location of the repair or advancement
• Date of the procedure
• Start and end time of the procedure
• Details of the repair or advancement technique used
• Any additional procedures performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 26350, ensure that the procedure meets the criteria specified in the code description. It is important to accurately document the location of the repair or advancement and whether a free graft was used. Additionally, consider any relevant coding guidelines and modifiers that may apply to the specific case.

8. Historical information

CPT 26350 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 healthcare provider repairs a flexor tendon in the hand of a patient who sustained an acute injury.
2. A surgeon performs a secondary repair of a flexor tendon in the finger that was not properly healed after a previous injury.
3. A hand specialist advances a flexor tendon in the hand to improve joint function in a patient with limited mobility.
4. A healthcare provider repairs a flexor tendon in the finger of a patient who experienced a laceration.
5. A surgeon performs a secondary repair of a flexor tendon in the hand to address chronic pain and limited range of motion.
6. A hand specialist advances a flexor tendon in the finger to improve grip strength in a patient with hand weakness.
7. A healthcare provider repairs a flexor tendon in the hand of a patient who sustained a sports-related injury.
8. A surgeon performs a secondary repair of a flexor tendon in the finger to correct a previous unsuccessful repair.
9. A hand specialist advances a flexor tendon in the hand to restore functionality in a patient with a congenital hand deformity.
10. A healthcare provider repairs a flexor tendon in the finger of a patient who experienced a workplace accident.