How To Use CPT Code 26685

CPT 26685 describes the open treatment of carpometacarpal dislocation, excluding the thumb, which includes internal fixation if performed, for each joint. 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 26685?

CPT 26685 can be used to describe the open treatment of carpometacarpal dislocation in the hand, excluding the thumb. This procedure involves repairing displaced bones in the joint through an incision near the wrist. If necessary, the provider may use hardware, such as plates or wires, to hold the bones in place during the healing process.

2. Official Description

The official description of CPT code 26685 is: ‘Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint.’

3. Procedure

1. The provider begins by making an incision over the dislocated joint, after the patient is appropriately prepped and anesthetized.
2. She then reduces the dislocated bones into their correct anatomical position.
3. If necessary, the provider may insert a metal plate or small wires to maintain the reduction.
4. The alignment of the bones is confirmed using imaging techniques.
5. The provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision.
6. A splint or brace may be applied to support the joint during the healing process.

4. Qualifying circumstances

CPT 26685 is used for patients who require open treatment of carpometacarpal dislocation in the hand, excluding the thumb. This procedure is performed when the bones in the joint are displaced and need to be repaired. The provider may use internal fixation, such as plates or wires, if necessary. It is important to note that this code specifically applies to each joint treated.

5. When to use CPT code 26685

CPT code 26685 should be used when a patient requires open treatment for carpometacarpal dislocation in the hand, excluding the thumb. This code is appropriate when the provider performs the procedure and includes internal fixation, if necessary, for each joint treated.

6. Documentation requirements

To support a claim for CPT 26685, the provider must document the following information:

• The diagnosis indicating the need for open treatment of carpometacarpal dislocation
• Details of the procedure performed, including the specific joints treated and whether internal fixation was used
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 26685, ensure that the procedure performed matches the description of the code. It is important to document the specific joints treated and whether internal fixation was used. Modifier 57, Decision for surgery, may be appended to an evaluation and management (E/M) service if the decision for surgery was made during the same encounter. It is crucial to use the appropriate diagnosis code that supports the need for the procedure.

8. Historical information

CPT 26685 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been two code changes. On January 1, 2002, the code was revised to include dislocations of the carpometacarpal joint, excluding the thumb, with or without internal or external fixation. Another change occurred on January 1, 2008, when the code was further revised to include open treatment of carpometacarpal dislocation, excluding the thumb, with or without internal or external fixation, for each joint.

9. Examples

1. A patient undergoes open treatment of carpometacarpal dislocation in the hand, excluding the thumb, with internal fixation for each joint.
2. The provider performs open treatment of carpometacarpal dislocation in the hand, excluding the thumb, without internal fixation, for each joint.
3. A patient requires open treatment of carpometacarpal dislocation in multiple joints of the hand, excluding the thumb, with internal fixation for each joint.
4. The provider performs open treatment of carpometacarpal dislocation in a single joint of the hand, excluding the thumb, with external fixation.
5. A patient undergoes open treatment of carpometacarpal dislocation in the hand, excluding the thumb, with external fixation and internal fixation for each joint.
6. The provider performs open treatment of carpometacarpal dislocation in the hand, excluding the thumb, with or without external fixation, for each joint.
7. A patient requires open treatment of carpometacarpal dislocation in the hand, excluding the thumb, with or without internal fixation, for each joint.
8. The provider performs open treatment of carpometacarpal dislocation in the hand, excluding the thumb, with external fixation and internal fixation for each joint, with or without external fixation, for each joint.
9. A patient undergoes open treatment of carpometacarpal dislocation in the hand, excluding the thumb, with external fixation and internal fixation for each joint, with or without external fixation, for each joint, with or without internal fixation, for each joint.