How To Use CPT Code 26474

CPT 26474 describes a surgical procedure known as tenodesis, which involves suturing a tendon to the distal interphalangeal joint, the joint closest to the fingernail. This article will provide an overview of CPT code 26474, 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 26474?

CPT 26474 is a code used to describe a surgical procedure called tenodesis. This procedure involves suturing a tendon to the distal interphalangeal joint, which is the joint nearest to the fingernail. The purpose of tenodesis is to improve the stability of the joint and enhance the patient’s overall hand function.

2. Official Description

The official description of CPT code 26474 is: ‘Tenodesis; of distal joint, each joint.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The provider makes an incision in the skin and dissects through the subcutaneous tissue to access the joint and tendon.
3. The provider incises the tendon and repositions it from its original location.
4. The tendon is then sutured onto the distal interphalangeal joint space to improve stability.
5. The provider closes the wound by suturing the soft tissue layers.

4. Qualifying circumstances

CPT 26474 is typically performed on patients who require improved stability at the distal interphalangeal joint. This procedure may be necessary for individuals with conditions such as joint instability, chronic dislocation, or ligamentous laxity. The decision to perform tenodesis is made by the provider based on the patient’s specific clinical presentation and the need for joint stabilization.

5. When to use CPT code 26474

CPT code 26474 should be used when a provider performs tenodesis on the distal interphalangeal joint. It is important to note that this code is specific to each joint, so if multiple joints require tenodesis, each joint should be reported separately using CPT code 26474.

6. Documentation requirements

To support a claim for CPT code 26474, the provider must document the following information:

• Patient’s diagnosis and the need for tenodesis
• Details of the procedure, including the specific joint(s) involved
• Date of the procedure
• Any additional procedures performed in conjunction with tenodesis
• Any complications or unexpected findings during the procedure
• Post-operative care instructions, if applicable

7. Billing guidelines

When billing for CPT code 26474, ensure that the procedure performed matches the description of tenodesis of the distal joint. It is important to accurately report the number of joints treated, as each joint should be billed separately using CPT code 26474. Additionally, follow any specific billing guidelines provided by the payer to ensure proper reimbursement for the procedure.

8. Historical information

CPT code 26474 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 undergoes tenodesis of the distal interphalangeal joint of their index finger to improve stability and function.
2. A provider performs tenodesis of the distal interphalangeal joint of the thumb to address chronic dislocation.
3. Tenodesis of the distal interphalangeal joint of the middle finger is performed on a patient with ligamentous laxity.
4. A provider performs tenodesis of the distal interphalangeal joint of the ring finger to address joint instability.
5. A patient undergoes tenodesis of the distal interphalangeal joint of their little finger to improve overall hand function.
6. Tenodesis of the distal interphalangeal joint of the thumb is performed on a patient with chronic joint dislocation.
7. A provider performs tenodesis of the distal interphalangeal joint of the index finger to address ligamentous laxity.
8. Tenodesis of the distal interphalangeal joint of the middle finger is performed on a patient with joint instability.
9. A patient undergoes tenodesis of the distal interphalangeal joint of their ring finger to improve stability and function.
10. Tenodesis of the distal interphalangeal joint of the little finger is performed on a patient with chronic joint dislocation.