How To Use CPT Code 26517

CPT 26517 describes a procedure used to treat instability of joints in two digits between the metacarpals and proximal phalanges. 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 26517?

CPT 26517 is a code used to describe a surgical procedure that addresses joint instability in two digits between the metacarpals and proximal phalanges. This procedure involves making an incision on the palmar side of the hand over the joint, freeing the joint capsule from the bones, and attaching it with increased tension to the metacarpal and phalanx. It is typically performed when there is instability or dislocation of the joint caused by injury or disease of the joint capsule.

2. Official Description

The official description of CPT code 26517 is: ‘Capsulodesis, metacarpophalangeal joint; 2 digits.’

3. Procedure

1. The provider begins by making an S-shaped incision on the palmar side of the hand over the joint between the metacarpal and proximal phalanx.
2. Next, the provider carefully incises the joint capsule and frees it from the bones.
3. The surface of the metacarpal head and the end of the proximal phalanx are then roughened to create a suitable surface for attachment.
4. The provider sutures the joint capsule onto the bony tissue or affixes it with wires, ensuring appropriate tension.
5. The same procedure is repeated on another digit if necessary.
6. Once stability is confirmed, the operative site is closed with sutures.

4. Qualifying circumstances

CPT 26517 is performed on patients with joint instability or dislocation in two digits between the metacarpals and proximal phalanges. This procedure is typically indicated when there is injury or disease of the joint capsule, leading to joint instability. It is important to note that this procedure is specific to treating instability in two digits and should not be used for a single digit or more than two digits.

5. When to use CPT code 26517

CPT code 26517 should be used when the provider performs a capsulodesis procedure on two digits between the metacarpals and proximal phalanges. It is important to accurately document the number of digits involved in the procedure to ensure proper coding and billing.

6. Documentation requirements

To support a claim for CPT 26517, the provider must document the following information:

• The diagnosis indicating joint instability or dislocation
• The specific digits involved in the procedure
• A detailed description of the procedure performed, including the incision, freeing of the joint capsule, roughening of the bone surfaces, and attachment of the capsule
• Confirmation of stability after the procedure
• Closure of the operative site
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 26517, ensure that the procedure is performed on two digits between the metacarpals and proximal phalanges. It is important to accurately document the number of digits involved to avoid any billing discrepancies. Additionally, be aware of any specific payer guidelines or modifiers that may be required for proper reimbursement.

8. Historical information

CPT 26517 was added to the Current Procedural Terminology system on January 1, 1990. The code was later revised on January 1, 2009 to clarify the description as ‘Capsulodesis, metacarpophalangeal joint; two digits.’

9. Examples

1. A patient with joint instability in the index and middle fingers undergoes a capsulodesis procedure on both digits using CPT code 26517.
2. A provider performs a capsulodesis procedure on the ring and little fingers of a patient with joint instability, utilizing CPT code 26517.
3. Two digits affected by joint instability in a patient’s hand are treated with a capsulodesis procedure using CPT code 26517.
4. A capsulodesis procedure is performed on the thumb and index finger of a patient with joint instability, coded with CPT 26517.
5. A provider addresses joint instability in the middle and ring fingers of a patient’s hand through a capsulodesis procedure, utilizing CPT code 26517.
6. Two digits affected by joint instability in a patient’s hand are treated with a capsulodesis procedure using CPT code 26517.
7. A patient with joint instability in the index and middle fingers undergoes a capsulodesis procedure on both digits using CPT code 26517.
8. A provider performs a capsulodesis procedure on the ring and little fingers of a patient with joint instability, utilizing CPT code 26517.
9. Two digits affected by joint instability in a patient’s hand are treated with a capsulodesis procedure using CPT code 26517.
10. A capsulodesis procedure is performed on the thumb and index finger of a patient with joint instability, coded with CPT 26517.