How To Use CPT Code 26496

CPT 26496 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 an overview of CPT code 26496, 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 26496?

CPT 26496 is a code used to describe the surgical procedure called 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. CPT 26496 is used when a provider performs a tendon transfer method other than those described in codes 26490, 26492, and 26494.

2. Official Description

The official description of CPT code 26496 is: ‘Opponensplasty; other methods.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the skin over the tendon and dissects down through the subcutaneous tissue to expose the tendon.
3. The provider isolates the muscle tendon and separates it from its attachment.
4. The provider transfers the tendon to another location to restore and supplement the opposition function of the thumb.

4. Qualifying circumstances

CPT 26496 is used when the provider performs opponensplasty using a tendon transfer method other than those described in codes 26490, 26492, and 26494. This procedure is typically performed on patients who require restoration of thumb opposition function.

5. When to use CPT code 26496

CPT code 26496 should be used when a provider performs opponensplasty using a tendon transfer method other than those described in codes 26490, 26492, and 26494. It is important to accurately document the specific method used in the procedure to ensure proper coding and billing.

6. Documentation requirements

To support a claim for CPT 26496, the provider must document the following information:

• Patient’s diagnosis and the need for opponensplasty
• Specific tendon transfer method used in the procedure
• Date of the procedure
• Details of the surgical technique employed
• Any additional procedures performed in conjunction with opponensplasty
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 26496, ensure that the procedure performed involves a tendon transfer method other than those described in codes 26490, 26492, and 26494. It is important to accurately document the specific method used in the procedure to support proper coding and billing. There are no specific guidelines regarding reporting CPT 26496 with other codes.

8. Historical information

CPT 26496 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 provider performs opponensplasty using a tendon transfer method other than those described in codes 26490, 26492, and 26494 to restore thumb opposition in a patient with a traumatic injury.
2. A patient with a congenital condition undergoes opponensplasty using a unique tendon transfer method to improve thumb opposition function.
3. A provider performs opponensplasty using a specialized tendon transfer technique to restore thumb opposition in a patient with a degenerative joint disease.
4. Using a different tendon transfer method, a provider performs opponensplasty to enhance thumb opposition in a patient with a chronic inflammatory condition.
5. A provider performs opponensplasty using an innovative tendon transfer method to restore thumb opposition in a patient with a neurological disorder.
6. For a patient with a thumb deformity, a provider performs opponensplasty using a distinct tendon transfer technique to improve thumb opposition function.
7. A provider performs opponensplasty using a unique tendon transfer method to restore thumb opposition in a patient with a history of repetitive strain injury.
8. Using a specialized tendon transfer technique, a provider performs opponensplasty to enhance thumb opposition in a patient with a connective tissue disorder.
9. A patient with a thumb injury undergoes opponensplasty using a different tendon transfer method to improve thumb opposition function.
10. A provider performs opponensplasty using an innovative tendon transfer method to restore thumb opposition in a patient with a thumb joint instability.