How To Use CPT Code 26727

CPT 26727 describes the percutaneous skeletal fixation of an unstable phalangeal shaft fracture in the proximal or middle phalanx of a finger or thumb, 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 26727?

CPT 26727 is used to describe a specific procedure performed by a healthcare provider to treat an unstable phalangeal shaft fracture in the proximal or middle phalanx of a finger or thumb. This procedure involves the use of wires, screws, or pins that are inserted through the skin to stabilize the fracture. Additionally, the provider performs manipulation or adjustment of the phalanx to realign the fractured bone.

2. Official Description

The official description of CPT code 26727 is: ‘Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with manipulation, each.’

3. Procedure

1. The healthcare provider begins by assessing the patient’s condition and determining the need for treatment of the phalangeal shaft fracture.
2. An X-ray is performed to examine the fractured bone and guide the provider during the procedure.
3. The provider then performs manipulation or adjustment of the phalanx to realign the fractured bone.
4. Using fluoroscopic imaging guidance, the provider inserts wires, screws, or pins through the skin and into the bone across the fracture to stabilize it.
5. After the fixation, the patient’s finger or thumb is placed in a brace or splint for approximately four weeks to support proper healing.
6. Follow-up X-rays may be performed to confirm the reduction of the fracture and monitor the healing process.

4. Qualifying circumstances

CPT 26727 is used for patients with an unstable phalangeal shaft fracture in the proximal or middle phalanx of a finger or thumb. The procedure is performed by a healthcare provider who is qualified to perform percutaneous skeletal fixation. The manipulation of the phalanx and the use of wires, screws, or pins are necessary to stabilize the fracture and promote proper healing.

5. When to use CPT code 26727

CPT code 26727 should be used when a healthcare provider performs percutaneous skeletal fixation with manipulation for an unstable phalangeal shaft fracture in the proximal or middle phalanx of a finger or thumb. It is important to note that this code should not be used for closed treatment of the fracture without manipulation or for open treatment with or without internal fixation implants.

6. Documentation requirements

To support a claim for CPT 26727, the healthcare provider must document the following information:

• Diagnosis of an unstable phalangeal shaft fracture in the proximal or middle phalanx of a finger or thumb
• Details of the manipulation performed to realign the fractured bone
• Description of the percutaneous skeletal fixation procedure, including the type of wires, screws, or pins used
• Date of the procedure
• Confirmation of the reduction of the fracture through post-procedure X-rays
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 26727, ensure that the procedure meets the criteria for percutaneous skeletal fixation with manipulation for an unstable phalangeal shaft fracture in the proximal or middle phalanx of a finger or thumb. It is important to use the appropriate CPT code based on the specific treatment performed. CPT code 26727 should not be reported with other codes for closed treatment without manipulation or open treatment with or without internal fixation implants.

8. Historical information

CPT 26727 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 percutaneous skeletal fixation with manipulation for an unstable phalangeal shaft fracture in the proximal phalanx of a finger.
2. A patient presents with an unstable phalangeal shaft fracture in the middle phalanx of their thumb, and a healthcare provider performs the necessary manipulation and fixation procedure.
3. During a sports injury, a patient sustains an unstable phalangeal shaft fracture in the proximal phalanx of their index finger, and a healthcare provider performs percutaneous skeletal fixation with manipulation.
4. A healthcare provider treats an unstable phalangeal shaft fracture in the middle phalanx of a patient’s ring finger by performing percutaneous skeletal fixation with manipulation.
5. A patient fractures the proximal phalanx of their thumb, resulting in an unstable phalangeal shaft fracture that requires percutaneous skeletal fixation with manipulation performed by a healthcare provider.
6. A healthcare provider performs percutaneous skeletal fixation with manipulation for an unstable phalangeal shaft fracture in the middle phalanx of a patient’s little finger.
7. A patient presents with an unstable phalangeal shaft fracture in the proximal phalanx of their middle finger, and a healthcare provider performs the necessary manipulation and fixation procedure.
8. During a workplace accident, a patient sustains an unstable phalangeal shaft fracture in the middle phalanx of their index finger, and a healthcare provider performs percutaneous skeletal fixation with manipulation.
9. A healthcare provider treats an unstable phalangeal shaft fracture in the proximal phalanx of a patient’s ring finger by performing percutaneous skeletal fixation with manipulation.