How To Use CPT Code 26565

CPT 26565 describes a specific procedure performed on the hand and fingers. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26565?

CPT 26565 is used to describe a surgical procedure that involves the excision of part of the metacarpal bone in the hand. This procedure is typically performed to correct conditions such as rotational deformities or abnormal bone growth. It is important to note that CPT 26565 should not be used to describe other procedures or conditions.

2. Official Description

The official description of CPT code 26565 is: ‘Osteotomy; metacarpal, each.’ This code specifically refers to the excision of part of the metacarpal bone in the hand. It is important to review the full code description and any associated notes for accurate coding and billing.

3. Procedure

1. During the procedure, the healthcare provider will make an incision over the palmar surface of the hand, specifically over the affected metacarpal area.
2. The incision is then extended through the muscles to expose the bone.
3. The provider will carefully excise the necessary portion of the metacarpal bone.
4. If required, screws or wire may be used to fix the excised bone in place.
5. The site is then irrigated and the area is repaired in layers using sutures.

4. Qualifying circumstances

CPT 26565 is typically performed on patients who have specific conditions that require the excision of part of the metacarpal bone. These conditions may include rotational deformities or abnormal bone growth. It is important to ensure that the procedure is medically necessary and appropriate for the patient’s condition before using this code.

5. When to use CPT code 26565

CPT code 26565 should be used when the provider performs an osteotomy on a metacarpal bone in the hand. This code should not be used for other procedures or conditions. It is important to review the code description and any associated guidelines to ensure accurate usage.

6. Documentation requirements

To support a claim for CPT 26565, the healthcare provider must document the following information:

• The patient’s diagnosis and the medical necessity of the procedure
• A detailed description of the procedure performed, including the specific metacarpal bone and the extent of the excision
• The date of the procedure
• The start and end time of the procedure
• Any additional procedures or services performed during the same encounter
• The provider’s signature

7. Billing guidelines

When billing for CPT 26565, it is important to ensure accurate coding and adherence to billing guidelines. The procedure should be performed by a qualified healthcare provider and should be medically necessary. It is also important to review any specific guidelines or requirements from the payer. Additionally, it is important to consider any modifiers that may be necessary for accurate billing.

8. Historical information

CPT 26565 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 surgeon performs an osteotomy on the metacarpal bone of the patient’s hand to correct a rotational deformity.
2. A hand specialist excises part of the metacarpal bone in the hand to address abnormal bone growth in a patient.
3. A patient undergoes a metacarpal osteotomy to correct a congenital hand deformity.
4. A provider performs an osteotomy on the metacarpal bone to treat a patient with a traumatic injury to the hand.
5. A surgeon performs an osteotomy on the metacarpal bone to address a chronic condition causing pain and limited hand function in a patient.
6. A hand specialist excises part of the metacarpal bone to correct a malunion following a previous fracture.
7. A patient undergoes a metacarpal osteotomy to address a nonunion of the bone.
8. A provider performs an osteotomy on the metacarpal bone to correct a deformity caused by a bone tumor.
9. A surgeon excises part of the metacarpal bone to address abnormal bone growth in a patient with a genetic disorder.
10. A hand specialist performs an osteotomy on the metacarpal bone to address a chronic inflammatory condition affecting the hand.