How To Use CPT Code 26562

CPT 26562 describes the repair of syndactyly, specifically the separation of congenitally joined fingers by incising between them. 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 26562?

CPT 26562 can be used to describe the repair of syndactyly, which involves the separation of congenitally joined fingers. This code is used when the provider makes an incision between the fused fingers to release them and free the underlying tissues. The repair may also involve the division or excision of bone and the release of fused nail beds with nail fold reconstruction.

2. Official Description

The official description of CPT code 26562 is: ‘Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails).’ This code represents the separation of a single web between two digits, with each web space considered a unit.

3. Procedure

1. The provider applies a tourniquet to restrict blood flow to the operative field.
2. A zigzag incision is made in the skin of the web between the fingers to release the affected digits and free the underlying tissues.
3. The skin flaps created by the web division are defatted.
4. The bones are separated, which may involve the removal of bone and placement of bone grafts if necessary for complete reconstruction of the digit.
5. Fused nails may be divided or partially removed, and the nail folds are reconstructed.
6. Attention is paid to maintaining vascularization to the flaps created during the web division.
7. A layered closure is performed using absorbable sutures.
8. Antibiotic ointment and a nonabsorbent bulky sterile dressing are applied over the hand, with cotton fluffs placed between the fingers.
9. An above-elbow splint or cast may be applied to immobilize and protect the hand.

4. Qualifying circumstances

CPT 26562 is performed on patients with syndactyly, which is the fusion of two or more digits by a web of tissue. The fusion may be partial or extend to the tips of the digits. In complex cases, the repair may involve bone, nails, or other structures. The procedure is typically performed when the condition causes functional impairment and is medically necessary.

5. When to use CPT code 26562

CPT code 26562 should be used when the provider performs the repair of syndactyly, involving bone, nails, or other complex structures in each web space. This code should not be used for repairs involving only skin flaps or skin flaps and grafts, as separate codes exist for those scenarios.

6. Documentation requirements

To support a claim for CPT 26562, the provider must document the following information:

• Patient’s diagnosis of syndactyly
• Description of the complexity of the repair, including involvement of bone, nails, or other structures
• Date of the procedure
• Details of the procedure, including the incision, separation of bones, division of fused nails, and reconstruction of nail folds
• Use of tourniquet, absorbable sutures, antibiotic ointment, and bulky sterile dressing
• Application of above-elbow splint or cast
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 26562, ensure that the procedure involves the repair of syndactyly in each web space, with complexity involving bone, nails, or other structures. It is important to follow the guidelines of the payer regarding modifiers, such as modifier 50 for bilateral procedures. Some payers may require the procedure to be reported twice, once with modifier LT for the left side and once with modifier RT for the right side. Check with the payer for specific reporting requirements.

8. Historical information

CPT 26562 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 repair of syndactyly involving bone and nails in the web space between the index and middle fingers of a patient.
2. A patient with syndactyly between the ring and little fingers undergoes a complex repair involving bone, nails, and reconstruction of nail folds.
3. A provider separates the fused fingers of a child with syndactyly in the web space between the thumb and index finger, involving bone and nails.
4. A complex repair of syndactyly is performed on a patient’s web space between the middle and ring fingers, involving bone, nails, and reconstruction of nail folds.
5. A provider performs the repair of syndactyly involving bone and nails in the web space between the ring and little fingers of a patient.
6. A patient with syndactyly between the index and middle fingers undergoes a complex repair involving bone, nails, and reconstruction of nail folds.
7. A provider separates the fused fingers of a child with syndactyly in the web space between the thumb and index finger, involving bone and nails.
8. A complex repair of syndactyly is performed on a patient’s web space between the middle and ring fingers, involving bone, nails, and reconstruction of nail folds.
9. A provider performs the repair of syndactyly involving bone and nails in the web space between the ring and little fingers of a patient.
10. A patient with syndactyly between the index and middle fingers undergoes a complex repair involving bone, nails, and reconstruction of nail folds.