How To Use CPT Code 26449

CPT 26449 describes a complex surgical procedure known as tenolysis, which involves releasing the extensor tendon of the finger from adhesions. 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 26449?

CPT 26449 is a code used to describe a complex surgical procedure called tenolysis. This procedure involves releasing the extensor tendon of the finger from adhesions, which are fibrous bands that form between tissues. The tenolysis procedure is performed by a healthcare provider to restore the normal gliding motion of the tendon over the joint.

2. Official Description

The official description of CPT code 26449 is: ‘Tenolysis, complex, extensor tendon, finger, including forearm, each tendon.’

3. Procedure

1. The healthcare provider begins by preparing and anesthetizing the patient.
2. An incision is made in the skin over the extensor tendon to be released in the finger.
3. The provider dissects through the subcutaneous tissue to expose the tendon.
4. Adhesions and scars formed over the tendon are broken and debrided.
5. The entire procedure extends from the finger to the forearm, requiring extensive effort to release the tendon from adhesions.
6. Hemostasis is achieved at the surgical site, and the wound is closed by suturing the soft tissue in layers.

4. Qualifying circumstances

CPT 26449 is used when a patient requires a complex tenolysis procedure to release the extensor tendon of the finger from adhesions. This procedure is typically performed after an injury or repair that has resulted in the formation of adhesions along the surface of the tendon. The tenolysis procedure is considered complex because it involves releasing the tendon from adhesions that extend from the finger to the forearm.

5. When to use CPT code 26449

CPT code 26449 should be used when a healthcare provider performs a complex tenolysis procedure to release the extensor tendon of the finger from adhesions. This code is appropriate when the procedure involves the release of each extensor tendon of the finger, including the forearm. It is important to accurately document the complexity and extent of the procedure to support the use of CPT code 26449.

6. Documentation requirements

To support a claim for CPT code 26449, the healthcare provider must document the following information:

• Reason for the tenolysis procedure and the presence of adhesions
• Details of the procedure, including the specific tendon released and the extent of the adhesions
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 26449, ensure that the procedure meets the criteria for a complex tenolysis of the extensor tendon of the finger, including the forearm. It is important to accurately document the complexity and extent of the procedure to support the use of this code. There are no specific guidelines regarding reporting CPT code 26449 with other codes.

8. Historical information

CPT code 26449 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 undergoes a complex tenolysis procedure to release the extensor tendon of their finger from adhesions that extend to the forearm.
2. A healthcare provider performs tenolysis on a patient’s finger to restore the normal gliding motion of the extensor tendon.
3. A complex tenolysis procedure is performed on a patient with adhesions along the extensor tendon of their finger and forearm.
4. A healthcare provider releases the extensor tendon of a patient’s finger from adhesions using a complex tenolysis procedure.
5. Tenolysis is performed on a patient’s finger and forearm to release the extensor tendon from adhesions.
6. A complex tenolysis procedure is performed to release the extensor tendon of a patient’s finger and restore its normal function.
7. A healthcare provider performs tenolysis on a patient’s finger and forearm to release the extensor tendon from adhesions.
8. Tenolysis is performed on a patient’s finger to improve the gliding motion of the extensor tendon.
9. A complex tenolysis procedure is performed on a patient with extensive adhesions along the extensor tendon of their finger and forearm.
10. A healthcare provider releases the extensor tendon of a patient’s finger from adhesions using a complex tenolysis procedure.