How To Use CPT Code 26499

CPT 26499 describes a procedure used to correct a curved finger deformity known as claw finger using a method that does not have a more specific code. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26499?

CPT 26499 is a code used to describe a procedure that corrects a curved finger deformity called claw finger. This procedure involves rearranging the location of a flexor tendon from the palm side to the side of the finger, allowing it to function as an extensor tendon. The specific method used for this correction does not have a more specific code available.

2. Official Description

The official description of CPT code 26499 is not available. Please refer to the provider’s documentation for more information on the specific procedure performed.

3. Procedure

1. The provider begins by making an incision on the side of the finger with the claw deformity.
2. The incision is extended to expose the flexor tendon.
3. A blunt hook is used to pull the flexor tendon out while flexing the finger.
4. The provider frees the tendon from surrounding soft tissues to allow for free movement.
5. A longitudinal incision is made on the palm near the wrist.
6. The provider dissects down to the level of the extensor tendon.
7. The flexor tendon, which has been freed by the incision on the finger, is located and pulled through the palm incision.
8. The provider splits the tendon strip, also known as a slip, into four sections.
9. The loose split ends of the tendon strip are left out from the palm incision.
10. An incision is made on the side of the finger where the tendon will be attached.
11. An instrument called a tunneller is inserted through the finger incision, with forceps attached to the instrument.
12. The tunneller is advanced through the lumbrical canal, a gap between the soft tissues of the thumb and index finger area.
13. The first slip section of the tendon, which is toward the thumb side, is pulled through the index finger incision.
14. The slip section is attached with sutures to the thumb side of the finger at the proximal phalanx.
15. This new location of the tendon causes extension of the joint between the metacarpal and proximal phalanx, correcting the claw finger deformity.
16. The same procedure can be performed on the other fingers to correct the deformity.
17. The provider may also attach the slips to tendon pulleys to release tension.
18. The operative sites are closed in layers, and the wrist is immobilized with a splint.

4. Qualifying circumstances

CPT 26499 is used when a provider performs a claw finger correction using a method that does not have a more specific code available. This procedure is typically performed on patients with a curved finger deformity that requires correction. The specific qualifying circumstances may vary depending on the patient’s condition and the provider’s clinical judgment.

5. When to use CPT code 26499

CPT code 26499 should be used when a provider performs a claw finger correction using a method that does not have a more specific code available. This code is appropriate when the specific procedure performed aligns with the description provided and there is no other more specific code that accurately represents the procedure.

6. Documentation requirements

To support a claim for CPT 26499, the provider must document the following information:

• Patient’s diagnosis and the need for claw finger correction
• Details of the specific procedure performed
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures or techniques used during the correction
• Any complications or unexpected findings
• Post-procedure instructions or recommendations
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 26499, ensure that the procedure performed aligns with the description provided and there is no other more specific code available. Follow the appropriate coding guidelines and documentation requirements for accurate billing. It is important to review the provider’s documentation and consult with coding guidelines to ensure proper reporting of CPT 26499.

8. Historical information

CPT 26499 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 provider performs a claw finger correction using a method that does not have a more specific code available on a patient with a congenital finger deformity.
2. A patient presents with a claw finger deformity due to a previous injury, and the provider performs a correction using a method that is not represented by any other specific code.
3. A provider performs a claw finger correction on a patient with rheumatoid arthritis using a method that does not have a more specific code available.
4. A patient with a claw finger deformity seeks correction, and the provider performs the procedure using a method that is not represented by any other specific code.
5. A provider performs a claw finger correction on a patient with a neurological condition using a method that does not have a more specific code available.
6. A patient with a claw finger deformity due to a tendon injury undergoes a correction procedure using a method that is not represented by any other specific code.
7. A provider performs a claw finger correction on a patient with a genetic disorder using a method that does not have a more specific code available.