How To Use CPT Code 26742

CPT 26742 describes the closed treatment of an articular fracture involving a metacarpophalangeal or interphalangeal joint, with manipulation, performed by a healthcare provider. 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 26742?

CPT 26742 is used to describe the closed treatment of an articular fracture that involves a metacarpophalangeal or interphalangeal joint. The procedure includes manipulation, or adjustment, of the fractured bone to restore its normal alignment. This code is used when the healthcare provider performs the closed treatment of the fracture without using any internal fixation devices.

2. Official Description

The official description of CPT code 26742 is: ‘Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure and administers anesthesia or sedation if necessary.
2. The provider then manipulates the fractured bone by applying a pushing or pulling force to realign the bones and reduce the fracture.
3. After the manipulation, the provider immobilizes the joint by placing the patient’s hand in a brace or splint.
4. The patient is instructed to wear the brace or splint for approximately four weeks to allow for proper healing of the fracture.
5. The provider may also perform an X-ray examination of the joint to confirm the reduction of the fracture.

4. Qualifying circumstances

CPT 26742 is used for patients who have an articular fracture involving a metacarpophalangeal or interphalangeal joint. The procedure is performed by a healthcare provider who manipulates the fractured bone to restore its normal alignment. This code is specifically for closed treatment without the use of any internal fixation devices.

5. When to use CPT code 26742

CPT code 26742 should be used when a healthcare provider performs a closed treatment of an articular fracture involving a metacarpophalangeal or interphalangeal joint, with manipulation, and without the use of any internal fixation devices. This code should not be used if the provider performs an open treatment of the fracture or if manipulation is not performed.

6. Documentation requirements

To support a claim for CPT code 26742, the healthcare provider must document the following information:

• Diagnosis of the articular fracture involving the metacarpophalangeal or interphalangeal joint
• Description of the manipulation technique used
• Date of the procedure
• Start and end time of the procedure
• Details of any additional procedures performed, such as X-ray examination
• Documentation of the immobilization method used, such as a brace or splint
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 26742, ensure that the procedure meets the criteria for closed treatment of an articular fracture involving a metacarpophalangeal or interphalangeal joint, with manipulation, and without the use of any internal fixation devices. It is important to accurately document the procedure and provide the necessary supporting documentation. CPT code 26742 should not be reported with other codes for open treatment or when internal fixation devices are used.

8. Historical information

CPT code 26742 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performs closed treatment with manipulation for an articular fracture involving the metacarpophalangeal joint of a patient’s index finger.
2. A patient sustains an articular fracture involving the interphalangeal joint of their thumb, and a healthcare provider performs closed treatment with manipulation to realign the fractured bone.
3. A healthcare provider performs closed treatment with manipulation for an articular fracture involving the metacarpophalangeal joint of a patient’s little finger.
4. An articular fracture involving the metacarpophalangeal joint of a patient’s middle finger is treated with closed treatment and manipulation by a healthcare provider.
5. A healthcare provider performs closed treatment with manipulation for an articular fracture involving the interphalangeal joint of a patient’s ring finger.
6. A patient presents with an articular fracture involving the metacarpophalangeal joint of their thumb, and a healthcare provider performs closed treatment with manipulation to restore the normal alignment of the fractured bone.
7. A healthcare provider performs closed treatment with manipulation for an articular fracture involving the metacarpophalangeal joint of a patient’s index finger.
8. An articular fracture involving the interphalangeal joint of a patient’s little finger is treated with closed treatment and manipulation by a healthcare provider.
9. A healthcare provider performs closed treatment with manipulation for an articular fracture involving the metacarpophalangeal joint of a patient’s middle finger.
10. A patient sustains an articular fracture involving the interphalangeal joint of their ring finger, and a healthcare provider performs closed treatment with manipulation to restore the normal alignment of the fractured bone.