How To Use CPT Code 26600

CPT 26600 describes the closed treatment of a metacarpal fracture without manipulation, each bone. 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 26600?

CPT 26600 is used to describe the closed treatment of a metacarpal fracture without manipulation, each bone. This code is used when a healthcare provider treats a fracture of the metacarpal bone without performing any surgical intervention or manipulation. The purpose of this procedure is to prevent deformity, relieve pain, and restore function to the affected hand.

2. Official Description

The official description of CPT code 26600 is: ‘Closed treatment of metacarpal fracture, single; without manipulation, each bone.’

3. Procedure

1. The healthcare provider examines the patient and confirms the presence of a metacarpal fracture using radiographic imaging.
2. If the fracture is not displaced, the provider does not need to manipulate it.
3. The provider typically applies a cast, such as a gauntlet cast, from the fingers down past the wrist to stabilize the fracture and prevent deformity.
4. The cast provides symptomatic relief for the patient and prevents potential complications and further injury to the local soft tissues.

4. Qualifying circumstances

CPT 26600 is used for patients who have a metacarpal fracture that does not require surgical intervention or manipulation. The provider must confirm the fracture through radiographic imaging. The procedure is typically performed without anesthesia.

5. When to use CPT code 26600

CPT code 26600 should be used when a healthcare provider performs closed treatment of a metacarpal fracture without manipulation. This code is appropriate when the fracture is not displaced and does not require surgical intervention. If manipulation is performed, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 26600, the healthcare provider must document the following information:

• Clinical assessment and documentation of the neurologic and vascular status
• Type of immobilization performed on the fracture, such as casting
• Start and end time of the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 26600, ensure that the procedure does not involve manipulation or surgical intervention. Use modifier 57, Decision for surgery, if the procedure involves an E/M service that results in a decision for surgery. It is important to document the type of care and treatment provided, as well as the diagnosis code that supports the need for the procedure. Additional supplies of casting materials may also be reported using the appropriate HCPCS codes.

8. Historical information

CPT 26600 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 patient presents with a non-displaced fracture of the second metacarpal bone. The healthcare provider applies a gauntlet cast to stabilize the fracture and prevent deformity.
2. A patient sustains a metacarpal fracture in a fall. The healthcare provider confirms the fracture through radiographic imaging and applies a cast to immobilize the fracture.
3. A patient fractures their fifth metacarpal bone while playing sports. The healthcare provider performs a closed treatment without manipulation and applies a cast for stabilization.
4. A patient presents with a metacarpal fracture that does not require surgical intervention. The healthcare provider applies a cast to immobilize the fracture and promote healing.
5. A patient fractures their third metacarpal bone in a car accident. The healthcare provider performs closed treatment without manipulation and applies a cast to support the healing process.
6. A patient sustains a metacarpal fracture in a workplace accident. The healthcare provider confirms the fracture and applies a cast to immobilize the fracture and prevent further injury.
7. A patient fractures their first metacarpal bone in a sports-related incident. The healthcare provider performs closed treatment without manipulation and applies a cast to promote healing.
8. A patient presents with a metacarpal fracture that does not require surgical intervention. The healthcare provider applies a cast to stabilize the fracture and prevent deformity.
9. A patient sustains a metacarpal fracture in a fall. The healthcare provider confirms the fracture through radiographic imaging and applies a cast to immobilize the fracture and support healing.
10. A patient fractures their fourth metacarpal bone while playing a musical instrument. The healthcare provider performs closed treatment without manipulation and applies a cast to promote healing and prevent deformity.