How To Use CPT Code 26490

CPT 26490 describes a surgical procedure known as opponensplasty, which involves the transfer of a tendon to restore the opposition function of the thumb. This article will provide a comprehensive overview of CPT code 26490, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of when to use this code.

1. What is CPT Code 26490?

CPT 26490 is a code used to describe the surgical procedure known as opponensplasty. This procedure involves the transfer of a tendon to restore the opposition function of the thumb. Thumb opposition refers to the ability of the thumb to move across the palm and oppose the other fingertips. The code should be used when a provider performs this specific tendon transfer for opponensplasty.

2. Official Description

The official description of CPT code 26490 is: ‘Opponensplasty; superficialis tendon transfer type, each tendon.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The provider makes an incision in the skin of the ring finger and dissects through the subcutaneous tissue to expose the tendon.
3. The flexor digitorum superficialis tendon is isolated and separated from its attachment.
4. The provider expands the natural split in the superficialis tendon and redirects the tendon to the thumb.
5. The split ends of the tendons are sutured to both sides of the metacarpophalangeal joint of the thumb at the point of attachment of the abductor pollicis brevis muscle.
6. Hemostasis is obtained at the surgical site, and the wound is closed by suturing the soft tissue in layers.

4. Qualifying circumstances

CPT code 26490 is used for patients who require opponensplasty, a surgical procedure to restore thumb opposition function. This procedure is typically performed on patients with conditions that have resulted in the loss or impairment of thumb opposition. The code should be used when a provider performs the superficialis tendon transfer type for opponensplasty.

5. When to use CPT code 26490

CPT code 26490 should be used when a provider performs the superficialis tendon transfer type for opponensplasty. It is important to accurately document the procedure and ensure that it meets the criteria outlined in the official description. This code should not be used for other types of opponensplasty procedures or when a graft or other surgical techniques are involved.

6. Documentation requirements

To support a claim for CPT code 26490, the provider must document the following information:

• Patient’s diagnosis and the need for opponensplasty
• Specific details of the procedure performed, including the superficialis tendon transfer type
• Date of the procedure
• Any additional relevant information, such as complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT code 26490, it is important to ensure that the procedure meets the criteria outlined in the official description. The code should only be used for the superficialis tendon transfer type for opponensplasty. Providers should also be aware of any specific billing guidelines or requirements set forth by payers or regulatory bodies. It is important to accurately document the procedure and any additional relevant information to support the claim.

8. Historical information

CPT code 26490 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 hand surgeon performing a superficialis tendon transfer for opponensplasty on a patient with thumb opposition impairment.
2. A plastic surgeon performing an opponensplasty procedure to restore thumb opposition function in a patient with a congenital condition.
3. An orthopedic surgeon performing a superficialis tendon transfer for opponensplasty on a patient who has lost thumb opposition due to a traumatic injury.
4. A hand therapist assisting a surgeon in performing a superficialis tendon transfer for opponensplasty on a patient with a degenerative condition affecting thumb opposition.
5. A hand surgeon performing an opponensplasty procedure to restore thumb opposition function in a patient with a neurological disorder.
6. A plastic surgeon performing a superficialis tendon transfer for opponensplasty on a patient with thumb opposition impairment caused by a previous surgical procedure.
7. An orthopedic surgeon performing an opponensplasty procedure to restore thumb opposition function in a patient with a chronic inflammatory condition.
8. A hand therapist assisting a surgeon in performing a superficialis tendon transfer for opponensplasty on a patient with thumb opposition impairment caused by repetitive strain injury.
9. A hand surgeon performing an opponensplasty procedure to restore thumb opposition function in a patient with a genetic disorder.
10. A plastic surgeon performing a superficialis tendon transfer for opponensplasty on a patient with thumb opposition impairment caused by a tumor.