How To Use CPT Code 26989

CPT 26989 describes a procedure performed on the hands or fingers that does not have a specific code. This article will cover the description, official guidelines, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 26989?

CPT 26989 is used to report a procedure on the hands or fingers that does not have a specific code available. It is used when the provider performs a procedure that is not represented by any of the standard and active CPT codes. This code allows for the reporting of unique procedures that do not have a specific code assigned to them.

2. Official Description

The official description of CPT code 26989 is not available. Please refer to the notes and guidelines provided by the American Medical Association (AMA) for further information on the use of this code.

3. Procedure

1. The provider performs a procedure on the hands or fingers that is not represented by any of the standard and active CPT codes.
2. The procedure may involve various techniques or interventions specific to the patient’s condition or needs.
3. The provider carefully documents the details of the procedure, including the specific steps taken and any instruments or tools used.
4. The procedure may be performed in a surgical setting or as part of a non-surgical treatment plan.
5. The provider ensures that the procedure is necessary and appropriate for the patient’s condition, taking into consideration the potential risks and benefits.
6. The provider may consult with other healthcare professionals or specialists to determine the best course of action for the patient.

4. Qualifying circumstances

CPT 26989 can be used when the provider performs a procedure on the hands or fingers that does not have a specific code available. This may occur when the procedure is unique or uncommon, and there is no existing code that accurately describes it. The provider must ensure that the procedure is necessary and appropriate for the patient’s condition, and that it meets the criteria for using an unlisted procedure code.

5. When to use CPT code 26989

CPT code 26989 should be used when the provider performs a procedure on the hands or fingers that does not have a specific code available. It is important to note that this code should only be used when there is no other appropriate code that accurately describes the procedure. It is not appropriate to use CPT 26989 if there is a specific code available that accurately represents the procedure being performed.

6. Documentation requirements

To support a claim for CPT 26989, the provider must ensure that the documentation includes the following information:

• A detailed description of the procedure performed on the hands or fingers
• The specific steps taken during the procedure
• The instruments or tools used during the procedure
• The reason for choosing CPT 26989 instead of a defined, active code
• Operative notes or other relevant documentation to justify the claim and avoid a possible denial

7. Billing guidelines

When billing for CPT 26989, it is important to follow the guidelines provided by the payer. Some general billing guidelines for unlisted procedure codes include:

• Submit a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code
• Include one or more similar codes and compare the service to those codes to justify the claim amount
• Include the operative notes or other relevant documentation to strengthen the claim
• Ensure that the payer considers claims with unlisted procedure codes on a case-by-case basis

8. Historical information

CPT 26989 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 hand surgeon performing a unique procedure to repair a complex finger fracture.
2. An orthopedic specialist using an innovative technique to treat a rare hand condition.
3. A plastic surgeon performing a customized procedure to reconstruct a finger after a traumatic injury.
4. A hand therapist using a specialized intervention to improve hand function in a patient with a neurological disorder.
5. An occupational therapist providing a tailored treatment to address hand weakness and improve fine motor skills in a patient with arthritis.
6. A hand surgeon performing a procedure to release a trapped nerve in the hand or fingers.
7. An interventional radiologist using a minimally invasive technique to treat a vascular condition in the hand.
8. A hand therapist using a unique splinting technique to support and immobilize a finger after surgery.
9. A hand surgeon performing a procedure to remove a foreign object embedded in the hand or fingers.
10. An orthopedic specialist using a novel approach to treat a complex hand or finger fracture.