How To Use CPT Code 26951

CPT 26951 describes the surgical procedure for amputation of a finger or thumb, either as a primary or secondary procedure, at any joint or phalanx level. 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 26951?

CPT 26951 is used to describe the surgical removal of a finger or thumb, either as a primary or secondary procedure, at any joint or phalanx level. This code includes the amputation of the bone, as well as the removal of nerve tissue. Primary amputation refers to the immediate removal of the finger or thumb after an acute injury or infection, while secondary amputation is performed after a previous amputation has failed to heal properly.

2. Official Description

The official description of CPT code 26951 is: ‘Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure.’

3. Procedure

1. The provider begins by making an incision in the skin over the site of interest.
2. They then dissect through the subcutaneous tissue and detach the muscles from the bone.
3. The provider ligates the blood vessels and removes the digital nerves to minimize the chances of neuroma formation.
4. Next, they make a cut in the bone at the level of a joint or phalanx and amputate the bone.
5. Finally, the provider performs direct closure of the wound by suturing the skin layers together.

4. Qualifying circumstances

CPT 26951 is performed when a patient has a partially amputated finger or thumb following a traumatic injury. The procedure may be done as a primary amputation immediately after the acute injury or infection, or as a secondary amputation after a previous amputation has failed to heal properly. The provider must perform the procedure with direct closure of the wound.

5. When to use CPT code 26951

CPT code 26951 should be used when a provider performs the surgical amputation of a finger or thumb at any joint or phalanx level, either as a primary or secondary procedure. This code should only be used when the provider performs direct closure of the wound. If the procedure involves the use of local advancement flaps, such as V-Y or hood, CPT code 26952 should be used instead.

6. Documentation requirements

To support a claim for CPT 26951, the provider must document the following information:

• Patient’s diagnosis and the need for amputation
• Specific details of the procedure, including the level of amputation and any neurectomies performed
• Date of the procedure
• Details of the wound closure, including the method used
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 26951, ensure that the procedure meets the criteria for a primary or secondary amputation of a finger or thumb at any joint or phalanx level. The provider must perform direct closure of the wound. It is important to note that CPT code 26951 should not be reported if other codes, such as CPT codes 26966 to 26968, have already been performed in the previous seven days. Additionally, consider the location of the testing when coding for pulmonary function tests (PFTs) as they have both a professional and technical component.

8. Historical information

CPT 26951 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 patient with a partially amputated finger due to a traumatic injury undergoes a primary amputation at the metacarpophalangeal joint, with direct closure of the wound.
2. A secondary amputation of a thumb is performed on a patient who had a previous amputation that failed to heal properly. The procedure involves amputating the thumb at the interphalangeal joint, with direct closure of the wound.
3. A patient with a finger infection requires a primary amputation at the distal interphalangeal joint, with direct closure of the wound.
4. A secondary amputation of a thumb is performed on a patient who developed complications following a previous amputation. The procedure involves amputating the thumb at the metacarpophalangeal joint, with direct closure of the wound.
5. A patient with a finger injury undergoes a primary amputation at the proximal interphalangeal joint, with direct closure of the wound.
6. A secondary amputation of a thumb is performed on a patient who experienced a failed primary amputation. The procedure involves amputating the thumb at the carpometacarpal joint, with direct closure of the wound.
7. A patient with a partially amputated finger due to a crush injury undergoes a primary amputation at the distal interphalangeal joint, with direct closure of the wound.