How To Use CPT Code 26518

CPT 26518 describes a procedure used to treat instability of joints in three or four digits, specifically 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 26518?

CPT 26518 is a code used to describe a procedure performed by a healthcare provider to address joint instability in three or four digits. This procedure involves making an incision on the palmar side of the hand over the joint between the metacarpal and proximal phalanx. The joint capsule is then incised and attached with increased tension to the metacarpal and phalanx, providing stability to the joint.

2. Official Description

The official description of CPT code 26518 is: ‘Capsulodesis, metacarpophalangeal joint; three or four digits.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The healthcare provider makes an S-shaped incision on the palmar side of the hand over the joint between the metacarpal and proximal phalanx.
3. The incision is taken down to the level of the joint capsule.
4. The provider frees the capsule from the bones and roughens the surface of the metacarpal head and end of the proximal phalanx.
5. The capsule is sutured on the bony tissue or affixed with wires with appropriate tension.
6. The same procedure is performed on two or three more digits.
7. After confirming stability, the operative site is closed with sutures.

4. Qualifying circumstances

CPT 26518 is used when a patient has instability in three or four digits, specifically between the metacarpals and proximal phalanges. This procedure is typically performed to address joint instability caused by injury or disease of the joint capsule. It is important to note that this procedure is specific to three or four digits and should not be used for a single digit or two digits.

5. When to use CPT code 26518

CPT code 26518 should be used when a healthcare provider performs the capsulodesis procedure on three or four digits to address joint instability. 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 26518, the healthcare provider must document the following information:

• Number of digits involved in the procedure (three or four)
• Description of the joint instability and the need for capsulodesis
• Date of the procedure
• Details of the surgical approach and technique used
• Confirmation of stability after the procedure
• Closure of the operative site
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 26518, ensure that the procedure is performed on three or four digits. It is important to accurately document the number of digits involved to support proper coding and billing. Additionally, be aware of any specific guidelines or requirements from insurance providers regarding the use of this code.

8. Historical information

CPT 26518 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2009, with the description being updated to specify ‘three or four digits’.

9. Examples

1. A healthcare provider performs capsulodesis on three digits of a patient with joint instability.
2. A patient undergoes capsulodesis on four digits to address joint instability caused by injury.
3. A healthcare provider performs capsulodesis on three digits of a patient with joint instability due to a specific disease.
4. A patient with joint instability in four digits undergoes capsulodesis to improve stability and function.
5. A healthcare provider performs capsulodesis on three digits of a patient with chronic joint instability.
6. A patient undergoes capsulodesis on four digits to address joint instability caused by a previous surgical procedure.
7. A healthcare provider performs capsulodesis on three digits of a patient with joint instability resulting from a sports injury.
8. A patient with joint instability in four digits undergoes capsulodesis to prevent further damage and improve overall hand function.
9. A healthcare provider performs capsulodesis on three digits of a patient with joint instability due to a congenital condition.
10. A patient undergoes capsulodesis on four digits to address joint instability caused by repetitive strain injury.