How To Use CPT Code 26546

CPT 26546 describes the procedure for repairing a nonunion deformity in the phalanx bones of the fingers or metacarpal bones of the hand. 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 26546?

CPT 26546 can be used to describe the repair of a nonunion deformity in the phalanx bones of the fingers or metacarpal bones of the hand. This code is used when the provider uses a graft, with or without external or internal fixation, to fix the nonunion and restore proper bone union.

2. Official Description

The official description of CPT code 26546 is: ‘Repair non-union, metacarpal or phalanx (includes obtaining bone graft with or without external or internal fixation)’

3. Procedure

1. The provider makes an incision over the dorsal surface of the hand and wrist, exposing the metacarpal or phalanx bones.
2. The provider smoothens the area of nonunion using a burr or other sharp object.
3. A graft of appropriate size is harvested to fill the empty space of nonunion.
4. The provider may use internal fixation devices like screws and pins to fix the graft in place.
5. After confirming proper fixation, the operative site is irrigated and closed in layers.

4. Qualifying circumstances

Patients eligible to receive CPT 26546 services are those with a nonunion deformity in the phalanx bones of the fingers or metacarpal bones of the hand. The procedure involves obtaining a bone graft, with or without external or internal fixation, to repair the nonunion. The provider must ensure that the patient is appropriately prepped and anesthetized before performing the procedure.

5. When to use CPT code 26546

CPT code 26546 should be used when a provider performs a repair procedure for a nonunion deformity in the phalanx bones of the fingers or metacarpal bones of the hand. This code should be used when a bone graft is obtained and used, with or without external or internal fixation, to fix the nonunion.

6. Documentation requirements

To support a claim for CPT 26546, the provider must document the following information:

• Patient’s diagnosis of nonunion deformity
• Details of the procedure performed, including the use of a bone graft and any external or internal fixation devices
• Date of the procedure
• Incision site and approach
• Confirmation of proper fixation
• Operative site irrigation and closure

7. Billing guidelines

When billing for CPT 26546, ensure that the procedure meets the criteria for a nonunion repair in the phalanx bones of the fingers or metacarpal bones of the hand. Use the appropriate CPT code based on the specific procedure performed. It is important to note that harvesting of the graft should not be reported separately.

8. Historical information

CPT 26546 was added to the Current Procedural Terminology system on January 1, 1997. The code was later revised on January 1, 2008 to include obtaining a bone graft with or without external or internal fixation.

9. Examples

1. A provider performs a repair procedure for a nonunion deformity in the phalanx bones of a patient’s finger, using a bone graft and internal fixation.
2. A patient presents with a nonunion deformity in the metacarpal bone of their hand, and the provider performs a repair procedure using a bone graft without external fixation.
3. A provider treats a nonunion deformity in the phalanx bones of a patient’s finger, using a bone graft and external fixation.
4. A patient has a nonunion deformity in the metacarpal bone of their hand, and the provider performs a repair procedure using a bone graft and internal fixation.
5. A provider repairs a nonunion deformity in the phalanx bones of a patient’s finger, using a bone graft and external fixation.
6. A patient presents with a nonunion deformity in the metacarpal bone of their hand, and the provider performs a repair procedure using a bone graft and internal fixation.
7. A provider treats a nonunion deformity in the phalanx bones of a patient’s finger, using a bone graft and external fixation.
8. A patient has a nonunion deformity in the metacarpal bone of their hand, and the provider performs a repair procedure using a bone graft and internal fixation.
9. A provider repairs a nonunion deformity in the phalanx bones of a patient’s finger, using a bone graft and external fixation.
10. A patient presents with a nonunion deformity in the metacarpal bone of their hand, and the provider performs a repair procedure using a bone graft and internal fixation.