How To Use CPT Code 26785

CPT 26785 describes the open treatment of a single interphalangeal joint dislocation, including internal fixation if necessary. 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 26785?

CPT 26785 can be used to describe the open treatment of a single interphalangeal joint dislocation. This procedure involves the provider performing an incision over the dislocated joint, adjusting the bones to realign the fragments, and potentially using internal fixation implants like screws or wires to fix the dislocation. The patient’s finger is then placed in a splint for four weeks to aid in the healing process.

2. Official Description

The official description of CPT code 26785 is: ‘Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed, single.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. Using an X-ray for guidance, the provider makes an incision over the dislocated joint.
3. The provider carefully adjusts the bones to realign the dislocated fragments.
4. If necessary, the provider may use internal fixation implants like screws, nails, or wires to stabilize the joint.
5. The provider closes the incision by suturing the skin layers together.
6. A splint is applied to the patient’s finger to immobilize the joint and aid in the healing process.
7. An X-ray examination may be performed to confirm the reduction of the dislocation.

4. Qualifying circumstances

CPT 26785 is used for the open treatment of a single interphalangeal joint dislocation. This procedure is performed when there is an abnormal separation of a joint in the finger or toe. The provider may use internal fixation implants if necessary to fix the dislocation. The patient must have a single dislocated joint that requires treatment.

5. When to use CPT code 26785

CPT code 26785 should be used when the provider performs the open treatment of a single interphalangeal joint dislocation, including internal fixation if necessary. This code should not be used for closed treatment of a dislocation or for percutaneous skeletal fixation. It is important to accurately document the procedure performed to ensure proper coding.

6. Documentation requirements

To support a claim for CPT 26785, the provider must document the following information:

• Patient’s diagnosis of interphalangeal joint dislocation
• Details of the procedure performed, including the use of internal fixation if applicable
• Date of the procedure
• Start and end time of the procedure
• Confirmation of reduction of the dislocation through an X-ray examination
• Any additional relevant information or complications encountered during the procedure

7. Billing guidelines

When billing for CPT 26785, ensure that the procedure performed is the open treatment of a single interphalangeal joint dislocation, including internal fixation if necessary. This code should not be reported with codes for closed treatment or percutaneous skeletal fixation of a dislocation. It is important to review the specific documentation requirements and guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 26785 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2008, which expanded the description to include the option of internal or external fixation.

9. Examples

1. A hand surgeon performs an open treatment of a single interphalangeal joint dislocation in a patient’s finger, using internal fixation with screws to stabilize the joint.
2. A podiatrist performs an open treatment of a single interphalangeal joint dislocation in a patient’s toe, without the need for internal fixation.
3. An orthopedic surgeon performs an open treatment of a single interphalangeal joint dislocation in a patient’s finger, using wires for internal fixation.
4. A plastic surgeon performs an open treatment of a single interphalangeal joint dislocation in a patient’s finger, using a combination of screws and wires for internal fixation.
5. An emergency room physician performs an open treatment of a single interphalangeal joint dislocation in a patient’s finger, without the need for internal fixation.
6. A hand therapist assists a hand surgeon in the open treatment of a single interphalangeal joint dislocation in a patient’s finger, providing support and post-operative care.
7. An orthopedic resident performs an open treatment of a single interphalangeal joint dislocation in a patient’s finger, under the supervision of an attending physician.
8. A plastic surgeon performs an open treatment of a single interphalangeal joint dislocation in a patient’s finger, using a combination of screws and plates for internal fixation.
9. A hand surgeon performs an open treatment of a single interphalangeal joint dislocation in a patient’s finger, using a combination of wires and external fixation for stabilization.
10. An orthopedic surgeon performs an open treatment of a single interphalangeal joint dislocation in a patient’s finger, using a combination of screws, wires, and external fixation for stabilization.