How To Use CPT Code 26500

CPT 26500 describes the reconstruction of a tendon pulley using local tissues as a separate procedure. 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 26500?

CPT 26500 can be used to describe the reconstruction of a tendon pulley using nearby soft tissues as a separate procedure. This code is used when a healthcare provider repairs a damaged tendon pulley, which is a ring-like structure around the tendon sheath that helps the tendon maintain its shape during finger movement. The provider reconstructs the pulley by removing the damaged part and suturing the trimmed end. They may also use nearby soft tissues, muscles, or tendons to patch the area for a durable repair.

2. Official Description

The official description of CPT code 26500 is: ‘Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure).’

3. Procedure

1. The healthcare provider makes a longitudinal incision over the joint of the metacarpal and proximal phalanx or over a joint between two phalanges.
2. They expose the tendon pulley that requires reconstruction.
3. The damaged part of the pulley is removed using a sharp instrument.
4. The provider sutures the trimmed end of the pulley.
5. If necessary, nearby soft tissues, muscles, or tendons are used to patch the area for a durable repair.
6. The operative wound is irrigated and sutured, and a splint is placed for immobilization.

4. Qualifying circumstances

CPT 26500 is performed on patients who require the reconstruction of a tendon pulley. This procedure is typically done for individuals with damaged tendon pulleys that affect the movement and shape of their fingers. The provider must use local tissues to reconstruct the pulley as a separate procedure.

5. When to use CPT code 26500

CPT code 26500 should be used when a healthcare provider performs the reconstruction of a tendon pulley using local tissues as a separate procedure. It is important to note that this code should not be reported if the provider performs a more extensive, related procedure on the same site during the same session.

6. Documentation requirements

To support a claim for CPT 26500, the healthcare provider must document the following information:

• The need for the reconstruction of the tendon pulley
• The specific technique used for the reconstruction
• Date of the procedure
• Details of the procedure, including the incision, removal of the damaged part, suturing, and use of nearby soft tissues
• Any additional procedures performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 26500, ensure that the procedure involves the reconstruction of a tendon pulley using local tissues as a separate procedure. Do not report CPT 26500 if a more extensive, related procedure is performed on the same site during the same session. It is important to follow the code’s definition, which identifies it as a separate procedure.

8. Historical information

CPT 26500 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 hand surgeon performing the reconstruction of a tendon pulley using local tissues as a separate procedure on a patient with a damaged pulley.
2. An orthopedic surgeon repairing a tendon pulley using nearby soft tissues as a separate procedure for a patient with impaired finger movement.
3. A plastic surgeon reconstructing a tendon pulley with local tissues as a separate procedure to restore finger function in a patient with a damaged pulley.
4. A hand therapist assisting a hand surgeon in the reconstruction of a tendon pulley using local tissues as a separate procedure for a patient with a finger deformity.
5. An occupational therapist working with a hand surgeon to reconstruct a tendon pulley using nearby soft tissues as a separate procedure to improve finger mobility in a patient with a damaged pulley.
6. A hand surgeon performing the reconstruction of a tendon pulley using local tissues as a separate procedure on a patient with a traumatic finger injury.
7. An orthopedic surgeon repairing a tendon pulley using nearby soft tissues as a separate procedure for a patient with a congenital hand deformity.
8. A plastic surgeon reconstructing a tendon pulley with local tissues as a separate procedure to improve finger function in a patient with a chronic hand condition.
9. A hand therapist assisting a hand surgeon in the reconstruction of a tendon pulley using local tissues as a separate procedure for a patient with a finger injury.
10. An occupational therapist working with a hand surgeon to reconstruct a tendon pulley using nearby soft tissues as a separate procedure to restore finger mobility in a patient with a degenerative hand condition.