How To Use CPT Code 26530

CPT 26530 describes a specific procedure performed on the hand and fingers. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26530?

CPT 26530 is a code used to describe a surgical procedure performed on the hand and fingers. It involves the excision of part or all of one or more of the metacarpal bones at the metacarpophalangeal joints. The purpose of this procedure is to correct deformity, reduce inflammation, and improve hand function.

2. Official Description

The official description of CPT code 26530 is: ‘Arthroplasty, metacarpophalangeal joint; each joint. Please note that to report carpometacarpal joint arthroplasty, a different code, 25447, should be used.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. An incision is made over the metacarpophalangeal joint (MCPJ).
3. Tendon and capsule releases may be performed to expose the neck and heads of the metacarpal bones.
4. Part or all of one or more of the metacarpal heads are excised.
5. A soft tissue spacer, such as a piece of fascia or an anchovy of tendon, is inserted between the bones to maintain space and reduce mobility.
6. The capsule over the metacarpals is closed, and the extensor tendons are realigned.
7. Bleeding is controlled, instruments are removed, and the incision is closed in layers.

4. Qualifying circumstances

CPT 26530 is performed on patients who require correction of deformity, reduction of inflammation, and improvement of hand function. It is typically used for conditions affecting the metacarpophalangeal joints, such as arthritis or other joint disorders. The procedure is performed by a qualified healthcare professional.

5. When to use CPT code 26530

CPT code 26530 should be used when a surgical procedure is performed on the metacarpophalangeal joint to excise part or all of one or more of the metacarpal bones. It is important to note that this code is specific to the metacarpophalangeal joint and should not be used for carpometacarpal joint arthroplasty, which has its own separate code (25447).

6. Documentation requirements

To support a claim for CPT 26530, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for the surgical procedure
• Details of the procedure performed, including the specific metacarpophalangeal joint(s) involved
• Date of the procedure
• Any additional procedures or interventions performed during the same session
• Any complications or unexpected findings
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 26530, ensure that the procedure performed is specifically for the metacarpophalangeal joint(s). If the procedure involves the carpometacarpal joint, a different code (25447) should be used. It is important to follow the payer’s guidelines and requirements for preauthorization, if applicable. Report this code for each joint replaced.

8. Historical information

CPT 26530 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 patient with severe arthritis in the metacarpophalangeal joint of their index finger undergoes CPT 26530 to excise part of the metacarpal bone and improve hand function.
2. A patient with a deformity in the metacarpophalangeal joint of their thumb undergoes CPT 26530 to correct the deformity and reduce inflammation.
3. A patient with a traumatic injury to the metacarpophalangeal joint of their middle finger undergoes CPT 26530 to improve hand function and reduce pain.
4. A patient with a chronic joint disorder in the metacarpophalangeal joint of their ring finger undergoes CPT 26530 to improve joint mobility and reduce inflammation.
5. A patient with a congenital abnormality in the metacarpophalangeal joint of their little finger undergoes CPT 26530 to correct the deformity and improve hand function.
6. A patient with a history of repetitive strain injury in the metacarpophalangeal joint of their thumb undergoes CPT 26530 to reduce inflammation and improve hand function.
7. A patient with rheumatoid arthritis affecting multiple metacarpophalangeal joints undergoes CPT 26530 for each affected joint to improve hand function and reduce inflammation.
8. A patient with a chronic joint disorder in the metacarpophalangeal joint of their index finger undergoes CPT 26530 to correct the deformity and reduce pain.
9. A patient with a traumatic injury to the metacarpophalangeal joint of their middle finger undergoes CPT 26530 to improve hand function and reduce inflammation.
10. A patient with a congenital abnormality in the metacarpophalangeal joint of their little finger undergoes CPT 26530 to correct the deformity and improve hand function.