How To Use CPT Code 26665

CPT 26665 describes the open treatment of a specific type of thumb fracture and dislocation, known as a Bennett fracture. 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 26665?

CPT 26665 can be used to describe the open treatment of a Bennett fracture, which involves repairing a fracture at the base of the thumb and the dislocation of the joint between the thumb bone and the wrist bone. This procedure includes internal fixation, which may involve the use of small nails or wires to secure the bones.

2. Official Description

The official description of CPT code 26665 is: ‘Open treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture), includes internal fixation, when performed.’

3. Procedure

1. The provider makes an L-shaped incision at the base of the thumb to access the fracture and dislocation.
2. The provider manipulates the fracture and dislocation into the correct position.
3. If necessary, the provider may use small nails or wires to stabilize the bones and ensure proper alignment.
4. The provider checks for bleeding and closes the incision.
5. A cast may be applied to further stabilize the fracture and dislocation during the healing process.

4. Qualifying circumstances

CPT 26665 is used for the open treatment of a specific type of thumb fracture and dislocation, known as a Bennett fracture. This procedure is performed when internal fixation is necessary to secure the bones and restore proper alignment. It is important to note that not all thumb fractures and dislocations will qualify for this specific CPT code.

5. When to use CPT code 26665

CPT code 26665 should be used when the provider performs an open treatment for a Bennett fracture of the thumb and includes internal fixation as part of the procedure. It is important to accurately document the specific details of the fracture and dislocation to support the use of this CPT code.

6. Documentation requirements

To support a claim for CPT 26665, the provider must document the following information:

• Specific details of the Bennett fracture and dislocation
• Description of the open treatment procedure performed
• Documentation of internal fixation, including the use of small nails or wires
• Date of the procedure
• Any additional procedures or services performed during the same encounter
• Signature of the provider

7. Billing guidelines

When billing for CPT 26665, ensure that the procedure performed meets the specific criteria for a Bennett fracture and includes internal fixation. It is important to accurately document the details of the procedure and any additional services provided during the same encounter. Be aware of any specific payer guidelines or modifiers that may be required for proper billing.

8. Historical information

CPT 26665 was added to the Current Procedural Terminology system on January 1, 1990. There was a code change on January 1, 2008, which expanded the description to include internal or external fixation.

9. Examples

1. A patient sustains a Bennett fracture of the thumb and undergoes open treatment with internal fixation.
2. A provider performs open treatment for a Bennett fracture of the thumb, including the use of small nails to stabilize the bones.
3. An individual presents with a Bennett fracture and dislocation, and the provider performs open treatment with internal fixation using wires.
4. A patient with a Bennett fracture of the thumb undergoes open treatment, which includes the use of small nails for internal fixation.
5. A provider performs open treatment for a Bennett fracture and dislocation, utilizing internal fixation with small wires.
6. An individual sustains a Bennett fracture and undergoes open treatment with internal fixation using small nails.
7. A patient presents with a Bennett fracture of the thumb, and the provider performs open treatment with internal fixation using wires.
8. An individual undergoes open treatment for a Bennett fracture and dislocation, which includes the use of small nails for internal fixation.
9. A provider performs open treatment for a Bennett fracture of the thumb, utilizing internal fixation with small wires.
10. A patient sustains a Bennett fracture and undergoes open treatment with internal fixation using small nails.