How To Use CPT Code 26455

CPT 26455 describes a surgical procedure known as tenotomy, specifically the open division of a flexor tendon in a finger. This article will provide an overview of CPT code 26455, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26455?

CPT 26455 is used to describe a surgical procedure called tenotomy, which involves the open division of a flexor tendon in a finger. This procedure is performed by a healthcare provider to correct deformities caused by congenital or acquired shortening of a muscle. By dividing the tendon, the muscle can return to its normal length, allowing the joint to straighten and correcting the deformity.

2. Official Description

The official description of CPT code 26455 is: ‘Tenotomy, flexor, finger, open, each tendon.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The healthcare provider makes an incision in the skin of the finger over the flexor tendon to be divided.
3. The provider dissects through the subcutaneous tissue to gain adequate exposure of the tendon.
4. The flexor tendon is incised to lengthen it, allowing the muscle to return to its normal length.
5. Hemostasis is achieved at the surgical site, and the wound is closed by suturing the soft tissue in layers.

4. Qualifying circumstances

CPT 26455 is used when a patient requires the surgical division of a flexor tendon in a finger to correct a deformity caused by congenital or acquired shortening of a muscle. This procedure is typically performed by a qualified healthcare provider who has the necessary training and expertise in tenotomy.

5. When to use CPT code 26455

CPT code 26455 should be used when a healthcare provider performs an open tenotomy of a flexor tendon in a finger. It is important to accurately document the procedure and ensure that it meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 26455, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for tenotomy
• Specific finger and flexor tendon involved
• Date of the procedure
• Details of the procedure, including the incision, dissection, tendon incision, and closure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 26455, ensure that the procedure performed meets the specific criteria outlined in the code description. It is important to accurately document the procedure and any additional services provided. CPT code 26455 should not be reported with other codes that describe similar procedures or services.

8. Historical information

CPT code 26455 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performs an open tenotomy of the flexor tendon in the index finger to correct a congenital deformity.
2. A patient with acquired shortening of the flexor tendon in the middle finger undergoes an open tenotomy procedure to restore normal finger function.
3. A healthcare provider performs an open tenotomy of the flexor tendon in the ring finger to correct a deformity caused by trauma.
4. A patient with a congenital shortening of the flexor tendon in the little finger undergoes an open tenotomy procedure to improve finger extension.
5. A healthcare provider performs an open tenotomy of the flexor tendon in the thumb to correct a deformity caused by a previous injury.
6. A patient with acquired shortening of the flexor tendon in the middle finger undergoes an open tenotomy procedure to restore normal finger function.
7. A healthcare provider performs an open tenotomy of the flexor tendon in the index finger to correct a congenital deformity.
8. A patient with a congenital shortening of the flexor tendon in the little finger undergoes an open tenotomy procedure to improve finger extension.
9. A healthcare provider performs an open tenotomy of the flexor tendon in the thumb to correct a deformity caused by a previous injury.
10. A patient with acquired shortening of the flexor tendon in the middle finger undergoes an open tenotomy procedure to restore normal finger function.