How To Use CPT Code 26540

CPT 26540 describes the repair of a tear in the collateral ligament of a metacarpophalangeal joint or interphalangeal joint. 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 26540?

CPT 26540 is used to describe the repair of a tear in the collateral ligament of a metacarpophalangeal joint or interphalangeal joint. This code is used when a healthcare provider surgically repairs the ligament tear to restore stability and function to the joint.

2. Official Description

The official description of CPT code 26540 is: ‘Repair of collateral ligament, metacarpophalangeal or interphalangeal joint.’

3. Procedure

1. The healthcare provider prepares the patient and administers anesthesia.
2. An incision is made over the affected joint, and the soft tissue is dissected to expose the metacarpophalangeal or interphalangeal joint.
3. The provider sutures the tear in the collateral ligament to repair it.
4. Any bleeding is controlled, and all instruments are removed.
5. The incision is closed in layers.

4. Qualifying circumstances

CPT 26540 is performed when a patient has a tear in the collateral ligament of a metacarpophalangeal joint or interphalangeal joint that requires surgical repair. This procedure is typically performed by a healthcare provider who specializes in hand and finger surgeries. The tear in the ligament must be significant enough to affect the stability and function of the joint.

5. When to use CPT code 26540

CPT code 26540 should be used when a healthcare provider performs a surgical repair of a tear in the collateral ligament of a metacarpophalangeal joint or interphalangeal joint. This code should not be used for other types of ligament repairs or repairs in different joints.

6. Documentation requirements

To support a claim for CPT 26540, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for ligament repair
• Details of the surgical procedure performed, including the specific ligament repaired
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the surgery

7. Billing guidelines

When billing for CPT 26540, ensure that the procedure performed is a repair of a tear in the collateral ligament of a metacarpophalangeal joint or interphalangeal joint. This code should not be reported with other codes unless there are separate and distinct procedures performed. Use the appropriate modifiers, such as modifier 80 for assistant surgeon or modifier AS for nonphysician practitioners serving as an assistant surgeon, if applicable.

8. Historical information

CPT 26540 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 repairing a tear in the collateral ligament of a patient’s metacarpophalangeal joint.
2. A orthopedic surgeon performing a surgical repair of a tear in the collateral ligament of a patient’s interphalangeal joint.
3. A plastic surgeon suturing a tear in the collateral ligament of a patient’s metacarpophalangeal joint.
4. An orthopedic specialist repairing a tear in the collateral ligament of a patient’s interphalangeal joint using a tendon graft.
5. A hand surgeon performing a surgical repair of a tear in the collateral ligament of a patient’s metacarpophalangeal joint with a prosthetic implant.
6. An orthopedic surgeon repairing a tear in the collateral ligament of a patient’s interphalangeal joint with a local tissue transfer.
7. A plastic surgeon suturing a tear in the collateral ligament of a patient’s metacarpophalangeal joint with a prosthetic implant and a local tissue transfer.
8. An orthopedic specialist repairing a tear in the collateral ligament of a patient’s interphalangeal joint with a prosthetic implant and a free tendon graft.
9. A hand surgeon performing a surgical repair of a tear in the collateral ligament of a patient’s metacarpophalangeal joint with a free tendon graft.
10. An orthopedic surgeon repairing a tear in the collateral ligament of a patient’s interphalangeal joint using a local tissue transfer and a free tendon graft.