How To Use CPT Code 26541

CPT 26541 describes a specific procedure involving the reconstruction of the collateral ligament in the metacarpophalangeal joint of the hand. This article will provide a comprehensive overview of CPT code 26541, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26541?

CPT 26541 is a code used to describe a surgical procedure in which the provider repairs the collateral ligament in the metacarpophalangeal joint of the hand. This ligament is responsible for holding the joint together from the sides. During the procedure, a tendon or fascial graft is used to replace the damaged part of the ligament.

2. Official Description

The official description of CPT code 26541 is: ‘Reconstruction, collateral ligament, metacarpophalangeal joint, single; with tendon or fascial graft (includes obtaining graft)’. This code specifically refers to the surgical reconstruction of the collateral ligament in the metacarpophalangeal joint using a tendon or fascial graft.

3. Procedure

1. The provider begins by making a longitudinal incision on the side of the affected joint between the metacarpal of the hand and the proximal phalanx of the finger.
2. Using a retractor, the provider exposes the collateral ligament and preserves the blood and nerve supply.
3. A tendon or fascia graft is harvested from the forearm, which is not separately reportable.
4. The provider drills holes in the lower end of the metacarpal and upper end of the proximal phalanx.
5. The graft is affixed to both bones using sutures.
6. After confirming the desired movement and stability of the joint, the provider irrigates the graft donor site and operative site wounds with antibiotics and closes the wounds with sutures.

4. Qualifying circumstances

CPT 26541 is typically performed on patients who have a damaged collateral ligament in the metacarpophalangeal joint of the hand. The procedure is indicated when the ligament requires reconstruction using a tendon or fascial graft. The provider must assess the patient’s condition and determine the need for this specific surgical intervention.

5. When to use CPT code 26541

CPT code 26541 should be used when a provider performs a reconstruction of the collateral ligament in the metacarpophalangeal joint of the hand using a tendon or fascial graft. It is important to note that this code should only be used for a single joint. If the provider performs the procedure on multiple joints, the code should be reported more than once.

6. Documentation requirements

To support a claim for CPT 26541, the provider must document the following information:

• Patient’s diagnosis and the need for collateral ligament reconstruction
• Details of the procedure, including the use of a tendon or fascial graft
• Date of the procedure
• Start and end time of the procedure
• Confirmation of desired movement and stability of the joint
• Details of any additional procedures or interventions performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 26541, ensure that the procedure meets the criteria outlined in the official description. It is important to report this code only for a single joint. Additionally, do not report a separate code for the harvesting of the graft, as it is included in CPT 26541.

8. Historical information

CPT 26541 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 undergoes a reconstruction of the collateral ligament in the metacarpophalangeal joint of their thumb using a tendon graft.
2. A provider performs a reconstruction of the collateral ligament in the metacarpophalangeal joint of the index finger using a fascial graft.
3. A patient requires a reconstruction of the collateral ligament in the metacarpophalangeal joint of their middle finger using a tendon graft.
4. A provider performs a reconstruction of the collateral ligament in the metacarpophalangeal joint of the ring finger using a fascial graft.
5. A patient undergoes a reconstruction of the collateral ligament in the metacarpophalangeal joint of their little finger using a tendon graft.
6. A provider performs a reconstruction of the collateral ligament in the metacarpophalangeal joint of the thumb using a fascial graft.
7. A patient requires a reconstruction of the collateral ligament in the metacarpophalangeal joint of their index finger using a tendon graft.
8. A provider performs a reconstruction of the collateral ligament in the metacarpophalangeal joint of the middle finger using a fascial graft.
9. A patient undergoes a reconstruction of the collateral ligament in the metacarpophalangeal joint of their ring finger using a tendon graft.
10. A provider performs a reconstruction of the collateral ligament in the metacarpophalangeal joint of the little finger using a fascial graft.