How To Use CPT Code 26433

CPT 26433 describes the repair of the distal insertion of the extensor tendon without the use of a 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 26433?

CPT 26433 is used to describe the repair of the distal insertion of the extensor tendon without the use of a graft. This procedure is performed to prevent further deformity and complications in patients with mallet finger, a condition that causes the tip of the finger to bend downward due to a blow to the finger.

2. Official Description

The official description of CPT code 26433 is: ‘Repair of extensor tendon, distal insertion, primary or secondary; without graft (eg, mallet finger)’

3. Procedure

1. The provider begins by making an incision over the tendon area and extending it down to the tendon level.
2. Using sutures, the provider repairs the extensor tendon at its distal insertion.
3. Any bleeding is controlled, and the skin incision is closed in layers.
4. An extension splint is applied to keep the joint in extension during the healing process.

4. Qualifying circumstances

CPT 26433 is performed on patients with mallet finger, a deformity of the distal interphalangeal (DIP) joint caused by a blow to the tip of the finger. The procedure can be performed as a primary repair within one to seven days of the injury or as a secondary repair more than seven days after the injury. The use of a graft is not involved in this procedure.

5. When to use CPT code 26433

CPT code 26433 should be used when the provider performs the repair of the distal insertion of the extensor tendon without the use of a graft. It is important to note that this code should not be used if a graft is used during the procedure.

6. Documentation requirements

To support a claim for CPT 26433, the provider must document the following information:

• Patient’s diagnosis of mallet finger
• Details of the repair procedure, including the use of sutures and absence of a graft
• Date of the procedure
• Any additional relevant information, such as the size of the incision or any complications encountered
• Signature of the provider

7. Billing guidelines

When billing for CPT 26433, ensure that the repair of the distal insertion of the extensor tendon is performed without the use of a graft. It is important to follow the guidelines for primary or secondary repair based on the timing of the procedure. Do not report CPT 26433 if a graft is used during the repair. Consider using modifier 51 if multiple procedures are performed during the same session.

8. Historical information

CPT 26433 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 presents with mallet finger, and the provider performs a repair of the distal insertion of the extensor tendon without the use of a graft.
2. A patient with a history of mallet finger undergoes a secondary repair of the distal insertion of the extensor tendon without the use of a graft.
3. A provider performs a primary repair of the distal insertion of the extensor tendon without the use of a graft on a patient who sustained a recent injury resulting in mallet finger.
4. A patient with chronic mallet finger undergoes a secondary repair of the distal insertion of the extensor tendon without the use of a graft.
5. A provider repairs the distal insertion of the extensor tendon without the use of a graft on a patient with mallet finger caused by a recent injury.
6. A patient with a history of mallet finger undergoes a primary repair of the distal insertion of the extensor tendon without the use of a graft.
7. A provider performs a secondary repair of the distal insertion of the extensor tendon without the use of a graft on a patient who sustained an injury resulting in mallet finger.
8. A patient presents with mallet finger, and the provider performs a primary repair of the distal insertion of the extensor tendon without the use of a graft.
9. A provider repairs the distal insertion of the extensor tendon without the use of a graft on a patient with chronic mallet finger.
10. A patient with a recent injury resulting in mallet finger undergoes a primary repair of the distal insertion of the extensor tendon without the use of a graft.