How To Use CPT Code 26715

CPT 26715 describes the open treatment of a single metacarpophalangeal dislocation, which involves the abnormal separation of a joint in the hand at the base of a finger. 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 26715?

CPT 26715 is used to describe the open treatment of a single metacarpophalangeal dislocation. This procedure involves the provider making an incision in the skin over the dislocated joint, dissecting through the subcutaneous tissue, and protecting the nerves and vessels. The provider then adjusts the bone to realign the dislocated joint and may use internal fixation implants like pins, wires, or screws to fix the dislocation. The wound is closed by suturing the skin layers together, and the metacarpophalangeal joint is placed in a brace or splint for four weeks. X-ray examinations may be performed to confirm the reduction of the dislocation.

2. Official Description

The official description of CPT code 26715 is: ‘Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed.’

3. Procedure

1. The provider makes an incision in the skin over the dislocated joint.
2. He dissects through the subcutaneous tissue, protecting the nerves and vessels.
3. The provider retracts the muscles to expose the metacarpophalangeal joint.
4. He adjusts the bone to realign the dislocated joint.
5. The provider may use internal fixation implants like pins, wires, or screws to fix the dislocation.
6. The wound is closed by suturing the skin layers together.
7. The metacarpophalangeal joint is placed in a brace or splint for four weeks.
8. X-ray examinations may be performed to confirm the reduction of the dislocation.

4. Qualifying circumstances

CPT 26715 is performed on patients with a single metacarpophalangeal dislocation that requires open treatment. The procedure may involve the use of internal fixation implants for stabilization. The patient must meet the criteria for this specific dislocation and be under the care of a qualified provider who can perform the procedure.

5. When to use CPT code 26715

CPT code 26715 should be used when the provider performs an open treatment of a single metacarpophalangeal dislocation and includes internal fixation, if performed. This code is appropriate when the procedure meets the specific criteria outlined in the official description.

6. Documentation requirements

To support a claim for CPT 26715, the provider must document the following information:

• Patient’s diagnosis of a single metacarpophalangeal dislocation
• Details of the procedure performed, including the incision, dissection, adjustment of the bone, and use of internal fixation implants
• Date of the procedure
• Start and end time of the procedure
• Confirmation of reduction of the dislocation through X-ray examinations
• Placement of the metacarpophalangeal joint in a brace or splint
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 26715, ensure that the procedure meets the criteria outlined in the official description. The use of internal fixation implants should be documented if performed. It is important to follow the specific guidelines for reporting this code and any associated codes. Be aware of any modifiers that may be required for accurate billing.

8. Historical information

CPT 26715 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including a code change on January 1, 2008, which expanded the description to include internal or external fixation.

9. Examples

1. A provider performs an open treatment of a single metacarpophalangeal dislocation in a patient who sustained a hand injury during a sports activity.
2. A surgeon performs an open reduction and internal fixation of a metacarpophalangeal dislocation in a patient involved in a motor vehicle accident.
3. A hand specialist performs an open treatment of a single metacarpophalangeal dislocation in a patient with a congenital hand deformity.
4. A provider performs an open reduction and internal fixation of a metacarpophalangeal dislocation in a patient with a history of chronic joint instability.
5. A surgeon performs an open treatment of a single metacarpophalangeal dislocation in a patient with a work-related hand injury.
6. A hand specialist performs an open reduction and internal fixation of a metacarpophalangeal dislocation in a patient with a history of rheumatoid arthritis.
7. A provider performs an open treatment of a single metacarpophalangeal dislocation in a patient who sustained a hand injury while playing a musical instrument.
8. A surgeon performs an open reduction and internal fixation of a metacarpophalangeal dislocation in a patient with a history of repetitive stress injury.
9. A hand specialist performs an open treatment of a single metacarpophalangeal dislocation in a patient with a history of gout.
10. A provider performs an open reduction and internal fixation of a metacarpophalangeal dislocation in a patient with a history of osteoarthritis.