How To Use CPT Code 26390

CPT 26390 describes the excision of a flexor tendon in the hand or finger, with the implantation of a synthetic rod for a delayed tendon graft. 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 26390?

CPT 26390 can be used to describe a surgical procedure in which a provider removes a flexor tendon in the hand or finger and replaces it with a synthetic rod. This procedure is performed to prepare the area for a future tendon graft. Each rod implantation should be reported with this code.

2. Official Description

The official description of CPT code 26390 is: ‘Excision flexor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod.’

3. Procedure

1. The provider begins by making an incision in the skin over the flexor tendon in the hand or finger.
2. They then dissect the underlying tissue to reach the flexor tendon.
3. The provider excises and removes the flexor tendon.
4. Next, they implant a synthetic rod in place of the removed tendon.
5. The rod remains in place for a period of time to stabilize the area and allow adjacent tissues to form a tube for a future tendon graft.
6. Finally, the provider stops any bleeding, and sutures are used to close the incision site.

4. Qualifying circumstances

CPT 26390 is typically performed when a patient has a torn flexor tendon in their hand or finger. This condition causes swelling, pain, and difficulty in hand or finger movement. The procedure is performed by a provider to prepare the area for a future tendon graft. It is important to note that CPT 26390 should not be reported in conjunction with codes 26170 or 26180, as the removal of the tendon is already included in CPT 26390.

5. When to use CPT code 26390

CPT code 26390 should be used when a provider performs the excision of a flexor tendon in the hand or finger and implants a synthetic rod for a delayed tendon graft. This code should be reported once for each rod implantation.

6. Documentation requirements

To support a claim for CPT 26390, the provider must document the following information:

• Patient’s diagnosis and the need for the excision and rod implantation
• Details of the procedure, including the specific flexor tendon excised and the type of synthetic rod used
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 26390, ensure that the procedure involves the excision of a flexor tendon in the hand or finger and the implantation of a synthetic rod. It is important to note that CPT 26390 should not be reported with codes 26170 or 26180. If a provider removes a synthetic rod and inserts a flexor tendon graft for each rod, CPT code 26392 should be used.

8. Historical information

CPT 26390 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 provider performs the excision of a flexor tendon in a patient’s finger, replacing it with a synthetic rod for a delayed tendon graft.
2. A surgeon removes a torn flexor tendon in a patient’s hand and implants a synthetic rod to prepare for a future tendon graft.
3. A hand specialist performs the excision of a flexor tendon in a patient’s finger, using a synthetic rod for stabilization and future grafting.
4. A provider replaces a damaged flexor tendon in a patient’s hand with a synthetic rod to facilitate a delayed tendon graft.
5. A surgeon performs the excision of a flexor tendon in a patient’s finger, inserting a synthetic rod to support the area for a future tendon graft.
6. A hand specialist removes a torn flexor tendon in a patient’s hand and replaces it with a synthetic rod to prepare for a future tendon graft.
7. A provider excises a damaged flexor tendon in a patient’s finger, implanting a synthetic rod to stabilize the area for a future tendon graft.
8. A surgeon replaces a torn flexor tendon in a patient’s hand with a synthetic rod to facilitate a delayed tendon graft.
9. A hand specialist performs the excision of a flexor tendon in a patient’s finger, using a synthetic rod for stabilization and future grafting.
10. A provider removes a damaged flexor tendon in a patient’s hand and replaces it with a synthetic rod to prepare for a future tendon graft.