How To Use CPT Code 26756

CPT 26756 describes the percutaneous skeletal fixation of a distal phalangeal fracture in the finger or thumb. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26756?

CPT 26756 is used to describe the percutaneous skeletal fixation of a distal phalangeal fracture in the finger or thumb. This procedure involves the use of screws, wires, or pins that are placed through the skin to treat the fracture. The phalanges are the bones present in the fingers and thumb, with three in each finger and two in the thumb.

2. Official Description

The official description of CPT code 26756 is: ‘Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each.’

3. Procedure

1. The provider begins by preparing and anesthetizing the patient.
2. An X-ray is performed to examine the fractured bone.
3. The provider manually adjusts the bones by pushing or pulling to reduce the fracture and bring the dislocated bones back to their normal alignment.
4. The provider drills the phalanx and inserts a wire or pin to hold the reduced fracture in place.
5. A brace or splint is applied to the patient’s digit to immobilize it for approximately four weeks.
6. An X-ray examination may be performed to confirm the reduction of the fracture.

4. Qualifying circumstances

CPT 26756 is used for patients with a distal phalangeal fracture in the finger or thumb that requires percutaneous skeletal fixation. The procedure is performed by a provider who manually adjusts the bones and inserts hardware, such as screws, wires, or pins, to stabilize the fracture. The patient must be appropriately prepped and anesthetized for the procedure.

5. When to use CPT code 26756

CPT code 26756 should be used when a provider performs percutaneous skeletal fixation of a distal phalangeal fracture in the finger or thumb. This code should be reported for each individual fracture treated using this procedure.

6. Documentation requirements

To support a claim for CPT 26756, the provider must document the following information:

• Diagnosis of the distal phalangeal fracture
• Details of the reduction procedure, including any manipulation performed
• Description of the hardware used for fixation
• Date of the procedure
• Confirmation of fracture reduction through post-procedure imaging

7. Billing guidelines

When billing for CPT 26756, ensure that the procedure meets the criteria for percutaneous skeletal fixation of a distal phalangeal fracture in the finger or thumb. It is important to accurately report the number of fractures treated using this code. There are specific codes for closed treatment without manipulation (26750), closed treatment with manipulation (26755), and open treatment with or without internal fixation (26765) that should be used for different scenarios.

8. Historical information

CPT 26756 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 provider performs percutaneous skeletal fixation of a distal phalangeal fracture in the thumb using screws.
2. A patient presents with a distal phalangeal fracture in their index finger, and the provider uses wires to stabilize the fracture.
3. A provider treats a distal phalangeal fracture in the middle finger of a patient using pins inserted through the skin.
4. A patient sustains a distal phalangeal fracture in their ring finger, and the provider performs percutaneous skeletal fixation using screws.
5. A provider treats a distal phalangeal fracture in the little finger of a patient using wires inserted through the skin.
6. A patient fractures their thumb, and the provider performs percutaneous skeletal fixation using pins.
7. A provider treats a distal phalangeal fracture in the index finger of a patient using screws inserted through the skin.
8. A patient presents with a distal phalangeal fracture in their middle finger, and the provider uses wires to stabilize the fracture.
9. A provider performs percutaneous skeletal fixation of a distal phalangeal fracture in the ring finger using pins.
10. A patient sustains a distal phalangeal fracture in their little finger, and the provider performs percutaneous skeletal fixation using screws.