How To Use CPT Code 26561

CPT 26561 describes the repair of syndactyly, a condition where two or more fingers are fused together by a web of tissue. 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 26561?

CPT 26561 is used to describe the surgical procedure performed to separate congenitally joined fingers. The provider makes an incision between the webbed skin and extends it to release the fingers completely. Skin flaps and grafts are used to repair the incision and ensure proper healing.

2. Official Description

The official description of CPT code 26561 is: ‘Repair of syndactyly (web finger) each web space; with skin flaps and grafts.’

3. Procedure

1. The provider makes a zigzag incision on the webbed skin between the joined fingers.
2. The incision is extended to the end of the webbing to release the fingers completely.
3. Skin flaps are created from the web division to repair the operative site.
4. A skin graft may be harvested and used in cases where additional repair is needed.
5. The provider ensures proper vascularization to the flaps created during the web division.
6. A layered closure is performed using absorbable sutures.
7. An antibiotic ointment and nonabsorbent bulky sterile dressing are applied.
8. An above-elbow splint or cast may be applied to immobilize and protect the hand.

4. Qualifying circumstances

CPT 26561 is performed on patients with syndactyly, a congenital condition where two or more fingers are fused together by a web of tissue. The procedure is necessary to separate the fingers and restore their normal function. It is important to ensure proper blood flow to the flaps created during the web division to promote healing and prevent complications.

5. When to use CPT code 26561

CPT code 26561 should be used when the provider performs the surgical repair of syndactyly using skin flaps and grafts. This code is specific to the repair of each web space, and multiple procedures may be performed at separate settings if additional webs need to be separated. It is important to follow the CPT guidelines for reporting bilateral procedures and to check with the payer for their preferred reporting method.

6. Documentation requirements

To support a claim for CPT 26561, the provider must document the following information:

• Patient’s diagnosis of syndactyly
• Description of the procedure performed, including the use of skin flaps and grafts
• Date of the procedure
• Details of the incision and repair, including any complications or additional procedures performed
• Application of splint or cast, if applicable
• Signature of the provider

7. Billing guidelines

When billing for CPT 26561, ensure that the procedure meets the criteria for syndactyly repair with skin flaps and grafts. Follow the CPT guidelines for reporting bilateral procedures and use appropriate modifiers if required by the payer. It is important to check with the payer for their specific billing requirements and to ensure accurate documentation to support the claim.

8. Historical information

CPT 26561 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 provider performs the surgical repair of syndactyly on a patient with fused fingers using skin flaps and grafts.
2. A patient with syndactyly undergoes a procedure to separate their webbed fingers, and skin flaps are used for the repair.
3. A provider performs the surgical repair of syndactyly on a patient with fused fingers, utilizing both skin flaps and grafts for the procedure.
4. A patient with syndactyly undergoes a surgical procedure to separate their webbed fingers, and the provider uses skin flaps and grafts to repair the incision.
5. A provider performs the surgical repair of syndactyly on a patient, utilizing skin flaps and grafts to separate their fused fingers.
6. A patient with syndactyly undergoes a surgical procedure to separate their webbed fingers, and the provider uses skin flaps and grafts for the repair.
7. A provider performs the surgical repair of syndactyly on a patient with fused fingers, utilizing skin flaps and grafts to separate and repair the webbed area.
8. A patient with syndactyly undergoes a procedure to separate their webbed fingers, and the provider uses skin flaps and grafts for the repair.
9. A provider performs the surgical repair of syndactyly on a patient, utilizing both skin flaps and grafts to separate and repair their fused fingers.
10. A patient with syndactyly undergoes a surgical procedure to separate their webbed fingers, and the provider uses skin flaps and grafts to repair the incision and restore normal finger function.