How To Use CPT Code 26550

CPT 26550 describes the procedure known as pollicization of a digit, which involves creating a thumb by rearranging bony and soft tissues from a finger, typically the index finger. 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 26550?

CPT 26550 can be used to describe the surgical procedure in which a thumb is created by rearranging bony and soft tissues from a finger, usually the index finger. This code is used when a provider performs the pollicization procedure to address the absence of a thumb, either due to a congenital condition or an injury.

2. Official Description

The official description of CPT code 26550 is: ‘Pollicization of a digit.’

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The provider makes incisions on both the palmar and back sides of the hand over the finger that will be used for pollicization, typically the index finger.
3. The incisions are extended down to the level of the bones while preserving the nerves and ligating the blood vessels.
4. The provider reduces the size of the finger to match the size of the thumb by removing the proximal phalanx shaft, leaving only the head of the proximal phalanx.
5. The remaining portion of the head of the proximal phalanx is attached to the same metacarpal bone but with an increased angle towards the outside.
6. The finger is rotated towards the inside on its axis to make it function like a thumb.
7. The provider rearranges the muscles and tendons to give movements similar to the thumb.
8. After establishing adequate stability and movement, the operative area is closed in layers, and flaps may be used if necessary.

4. Qualifying circumstances

Pollicization of a digit is performed in patients who have an absence of a thumb, either by birth or due to an injury. This procedure is typically done to improve hand function and enable the patient to grasp objects effectively. The provider must carefully assess the patient’s condition and determine if pollicization is the appropriate course of action.

5. When to use CPT code 26550

CPT code 26550 should be used when a provider performs the pollicization procedure to create a thumb from a finger. It is important to ensure that the procedure is performed for the appropriate indications and that the patient meets the qualifying circumstances mentioned above.

6. Documentation requirements

To support a claim for CPT 26550, the provider must document the following information:

• Patient’s diagnosis and the need for pollicization
• Details of the procedure, including the finger used for pollicization
• Date of the procedure
• Any additional procedures performed during the same operative session
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 26550, ensure that the procedure is performed by a qualified provider and that the documentation supports the medical necessity of the procedure. It is important to follow the specific guidelines provided by the payer and to use the appropriate modifiers if required. Additionally, consider any bundling or unbundling rules that may apply to the procedure.

8. Historical information

CPT 26550 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 provider performing pollicization of the index finger to create a thumb in a patient born without a thumb.
2. A surgeon performing pollicization of the middle finger to create a thumb in a patient who lost their thumb in an accident.
3. A hand specialist performing pollicization of the ring finger to create a thumb in a patient with a congenital thumb deformity.
4. A plastic surgeon performing pollicization of the little finger to create a thumb in a patient with a thumb amputation.
5. An orthopedic surgeon performing pollicization of the thumb to create a more functional thumb in a patient with thumb hypoplasia.
6. A reconstructive surgeon performing pollicization of the thumb to improve hand function in a patient with a thumb injury.
7. A hand surgeon performing pollicization of the thumb to address thumb absence in a patient with a congenital hand anomaly.
8. A plastic surgeon performing pollicization of the thumb to restore thumb function in a patient with a traumatic thumb avulsion.
9. An orthopedic specialist performing pollicization of the thumb to improve hand grip in a patient with thumb aplasia.
10. A hand surgeon performing pollicization of the thumb to create a more functional thumb in a patient with thumb duplication.