How To Use CPT Code 26412

CPT 26412 describes the repair of extensor tendons in the hand using a free 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 26412?

CPT 26412 can be used to describe the repair of extensor tendons in the hand using a free graft. This code is used when one or more tendons in the hand have a laceration or rupture, resulting in the loss of normal hand movements. The provider performs a primary repair within seven days of the injury or a secondary repair if more than seven days have passed since the injury.

2. Official Description

The official description of CPT code 26412 is: ‘Repair, extensor tendon, hand, primary or secondary; with free graft (includes obtaining graft), each tendon.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. An incision is made above the tear in each torn tendon.
3. The provider carefully avoids injury to the digital nerve and neurovascular bundles while making the incision deeper.
4. A skin flap is elevated to expose the thin tendon ends.
5. A free tendon graft is taken from a healthy part of the patient’s body.
6. The free graft is used to replace the torn tendon, ensuring a good clinical functional result.
7. The wound is irrigated with antibiotics, and the incision is sutured.
8. A postoperative dressing and splint are applied to support the hand during the healing process.

4. Qualifying circumstances

CPT 26412 is used when the provider repairs extensor tendons in the hand using a free graft. This procedure is performed when one or more tendons have a laceration or rupture, leading to the loss of normal hand movements. The repair can be classified as either primary or secondary, depending on the timing of the procedure in relation to the injury. The provider must carefully identify and repair each torn tendon, ensuring the use of a free graft to achieve a good clinical functional result.

5. When to use CPT code 26412

CPT code 26412 should be used when the provider performs a repair of extensor tendons in the hand using a free graft. This code is appropriate when the tendons have a laceration or rupture, resulting in the loss of normal hand movements. The repair can be classified as either primary or secondary, depending on the timing of the procedure in relation to the injury. It is important to accurately document the details of the repair and the use of a free graft to support the use of CPT code 26412.

6. Documentation requirements

To support a claim for CPT code 26412, the provider must document the following information:

• Patient’s diagnosis and the need for extensor tendon repair
• Details of the repair procedure, including the use of a free graft
• Date of the procedure
• Specific tendons repaired
• Any additional procedures performed during the same session
• Postoperative care instructions
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 26412, ensure that the provider performs the repair using a free graft and documents the details of the procedure. It is important to accurately report the specific tendons repaired and any additional procedures performed during the same session. CPT code 26412 should not be reported if the repair is performed without a free graft, in which case CPT code 26410 should be used. It is also important to follow any specific billing guidelines provided by the payer to ensure proper reimbursement.

8. Historical information

CPT code 26412 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 patient sustains a laceration to the extensor tendons in their hand and undergoes a repair procedure using a free graft.
2. A provider performs a secondary repair of extensor tendons in the hand using a free graft more than seven days after the injury.
3. A patient presents with a rupture of the extensor tendons in their hand and undergoes a primary repair procedure with a free graft.
4. A provider repairs multiple torn extensor tendons in the hand using free grafts during a single procedure.
5. A patient experiences a laceration to the extensor tendons in their hand and undergoes a repair procedure with a free graft to restore normal hand movements.
6. A provider performs a secondary repair of extensor tendons in the hand using a free graft to improve hand function.
7. A patient sustains a rupture of the extensor tendons in their hand and undergoes a primary repair procedure with a free graft to regain hand mobility.
8. A provider repairs multiple torn extensor tendons in the hand using free grafts, resulting in improved hand function.
9. A patient presents with a laceration to the extensor tendons in their hand and undergoes a repair procedure with a free graft to restore hand functionality.
10. A provider performs a secondary repair of extensor tendons in the hand using a free graft to enhance hand movements.