How To Use CPT Code 26471

CPT 26471 describes a surgical procedure that involves suturing a tendon to the proximal interphalangeal joint of a finger to improve joint stability. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26471?

CPT 26471 is used to describe a surgical procedure in which a tendon is affixed to the proximal interphalangeal joint of a finger. This procedure aims to enhance the stability of the joint and improve the patient’s overall hand function.

2. Official Description

The official description of CPT code 26471 is: ‘Tenodesis; of proximal interphalangeal joint, each joint.’

3. Procedure

1. The patient is prepared and anesthetized for the procedure.
2. An incision is made in the skin, allowing the provider to access the joint and tendon.
3. The tendon is incised and repositioned to the proximal interphalangeal joint.
4. The provider sutures the tendon onto the joint space, improving stability.
5. The wound is closed by suturing the soft tissue layers.

4. Qualifying circumstances

CPT 26471 is performed on patients who require improved stability at the proximal interphalangeal joint of a finger. This procedure is typically indicated for individuals with conditions such as ligamentous instability, chronic dislocation, or joint laxity. The patient must have a medical necessity for the procedure, and the provider must determine that tenodesis is the appropriate treatment option.

5. When to use CPT code 26471

CPT code 26471 should be used when a provider performs a tenodesis procedure on the proximal interphalangeal joint of a finger. It is important to ensure that the procedure meets the specific criteria outlined in the official description to accurately report this code.

6. Documentation requirements

To support a claim for CPT 26471, the provider must document the following information:

• Indication for the procedure, including the patient’s diagnosis and medical necessity
• Details of the procedure, including the specific tendon used and the joint involved
• Date of the procedure
• Any additional procedures or interventions performed during the same session
• Post-operative instructions or recommendations
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 26471, ensure that the procedure meets the criteria outlined in the official description. It is important to accurately document the details of the procedure and any additional services provided during the same session. Review the payer’s guidelines and policies to ensure proper reimbursement for this procedure.

8. Historical information

CPT 26471 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 patient with chronic dislocation of the proximal interphalangeal joint undergoes tenodesis to improve joint stability.
2. A professional athlete sustains a ligamentous injury to the proximal interphalangeal joint and requires tenodesis for optimal hand function.
3. A patient with joint laxity undergoes tenodesis to address recurrent subluxation of the proximal interphalangeal joint.
4. A musician with ligamentous instability in the finger joint undergoes tenodesis to enhance finger dexterity and performance.
5. A patient with chronic pain and instability in the proximal interphalangeal joint undergoes tenodesis to alleviate symptoms and improve hand function.
6. A patient with a history of failed conservative treatment for chronic dislocation of the proximal interphalangeal joint undergoes tenodesis as a surgical intervention.
7. A patient with joint hypermobility syndrome undergoes tenodesis to address recurrent dislocation of the proximal interphalangeal joint.
8. A construction worker with ligamentous instability in the finger joint undergoes tenodesis to prevent further injury and improve hand strength.
9. A patient with chronic joint laxity and pain in the proximal interphalangeal joint undergoes tenodesis to stabilize the joint and alleviate symptoms.
10. A patient with a history of traumatic injury to the proximal interphalangeal joint undergoes tenodesis to restore joint stability and function.