How To Use CPT Code 26605

CPT 26605 describes the closed treatment of a metacarpal fracture with manipulation. 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 26605?

CPT 26605 can be used to describe the closed treatment of a metacarpal fracture with manipulation. This code is used when a healthcare provider performs a closed reduction of each metacarpal bone fracture with manipulation to prevent deformity, relieve pain, and restore function.

2. Official Description

The official description of CPT code 26605 is: ‘Closed treatment of metacarpal fracture, single; with manipulation, each bone.’

3. Procedure

1. The healthcare provider examines the patient and confirms the fracture using radiographic imaging.
2. The patient is prepped and, if necessary, a local anesthetic is administered.
3. The provider manipulates the fracture into the correct position without opening the fracture site.
4. A cast, such as a gauntlet cast, is applied from the fingers down past the wrist to stabilize the fracture and prevent deformity.

4. Qualifying circumstances

Patients eligible for CPT 26605 are those with a metacarpal bone fracture that requires closed treatment with manipulation. The procedure is performed to prevent deformity, relieve pain, and restore function. The healthcare provider must confirm the fracture through radiographic imaging and use a cast to stabilize the fracture.

5. When to use CPT code 26605

CPT code 26605 should be used when a healthcare provider performs closed treatment of a single metacarpal fracture with manipulation. This code is appropriate when the fracture requires manipulation to restore normal anatomy without opening the fracture site. If the procedure involves an E/M service that results in a decision for surgery, modifier 57 should be used.

6. Documentation requirements

To support a claim for CPT 26605, the healthcare provider must document the following information:

• Clinical assessment and documentation of neurologic and vascular status
• Type of immobilization performed on the fracture
• Date and time of the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 26605, ensure that the procedure involves closed treatment of a single metacarpal fracture with manipulation. Modifier 57 should be used if the procedure involves an E/M service that results in a decision for surgery. Additional supplies of casting materials may be reported using HCPCS codes A4580 or A4590.

8. Historical information

CPT 26605 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 healthcare provider performs closed treatment with manipulation on a patient with a fractured metacarpal bone to restore normal anatomy and prevent deformity.
2. Using radiographic imaging, a provider confirms a metacarpal fracture and performs closed treatment with manipulation to relieve the patient’s pain and restore function.
3. A patient with a metacarpal fracture undergoes closed treatment with manipulation to prevent deformity and promote healing.
4. A healthcare provider manipulates a fractured metacarpal bone into the correct position and applies a cast to stabilize the fracture and facilitate healing.
5. Using closed treatment with manipulation, a provider restores normal anatomy and function in a patient with a metacarpal fracture.
6. A patient with a metacarpal fracture undergoes closed treatment with manipulation to alleviate pain and improve hand function.
7. A healthcare provider performs closed treatment with manipulation on a patient with a metacarpal fracture to prevent deformity and promote healing.
8. Using radiographic imaging, a provider confirms a metacarpal fracture and performs closed treatment with manipulation to restore normal anatomy and function.
9. A patient with a metacarpal fracture undergoes closed treatment with manipulation to relieve pain and improve hand function.
10. A healthcare provider manipulates a fractured metacarpal bone into the correct position and applies a cast to stabilize the fracture and promote healing.