How To Use CPT Code 26420

CPT 26420 describes the repair of an extensor tendon in the finger 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 26420?

CPT 26420 can be used to describe the repair of an extensor tendon in the finger using a free graft. This code is used when the provider performs either a primary or secondary repair of the extensor tendon, and includes obtaining the graft from the palmaris longus or plantaris tendon.

2. Official Description

The official description of CPT code 26420 is: ‘Repair, extensor tendon, finger, primary or secondary; with free graft (includes obtaining graft) each tendon.’

3. Procedure

1. The provider makes an incision in the skin over the injured extensor tendon in the finger.
2. They dissect through the subcutaneous tissue to gain exposure of the extensor tendon.
3. The provider repairs the extensor tendon to restore its function.
4. They obtain a graft from the palmaris longus or plantaris tendon and attach it to the extensor tendon to ensure sufficient length for repair.
5. Hemostasis is achieved at the surgical site and the wound is closed by suturing the soft tissue in layers.

4. Qualifying circumstances

CPT 26420 is used for patients who have an injury to the extensor tendon in the finger that requires repair. The repair can be either a primary repair, done within a few days of the injury, or a secondary repair, done at least a few days after the initial injury or after a previous surgical repair.

5. When to use CPT code 26420

CPT code 26420 should be used when the provider performs a repair of the extensor tendon in the finger using a free graft. This code should be used for each tendon repaired.

6. Documentation requirements

To support a claim for CPT 26420, the provider must document the following information:

• Patient’s diagnosis and the need for extensor tendon repair
• Whether the repair is primary or secondary
• Date of the procedure
• Details of the procedure, including the incision, dissection, repair, grafting, and closure
• Number of tendons repaired
• Signature of the provider

7. Billing guidelines

When billing for CPT 26420, ensure that the procedure involves the repair of the extensor tendon in the finger using a free graft. Use one unit of this code for each tendon repaired. It is important to note that CPT code 26420 should not be reported if the repair is performed without using a graft, in which case CPT code 26418 should be used instead.

8. Historical information

CPT 26420 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 repairing the extensor tendon in the index finger using a free graft.
2. A surgeon performing a secondary repair of the extensor tendon in the middle finger using a free graft.
3. An orthopedic specialist repairing the extensor tendon in the ring finger using a free graft.
4. A hand surgeon performing a primary repair of the extensor tendon in the little finger using a free graft.
5. A plastic surgeon repairing the extensor tendon in the thumb using a free graft.
6. An orthopedic specialist performing a secondary repair of the extensor tendon in the index finger using a free graft.
7. A hand surgeon repairing the extensor tendon in the middle finger using a free graft.
8. A provider performing a primary repair of the extensor tendon in the ring finger using a free graft.
9. An orthopedic specialist repairing the extensor tendon in the little finger using a free graft.
10. A plastic surgeon performing a secondary repair of the extensor tendon in the thumb using a free graft.