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The CPT® Code 26370 refers to the surgical procedure involving the repair or advancement of the flexor digitorum profundus (FDP) tendon, specifically when the flexor digitorum superficialis (FDS) tendon remains intact. The FDP tendon is crucial for finger flexion, extending from the upper anterior and medial aspects of the ulna to the wrist, where it divides into four tendons that insert at the palmar base of the distal phalanx of each finger. In this procedure, a primary repair or advancement is performed on the FDP tendon, which is typically indicated when the tendon has been severed due to injury. The repair is ideally conducted within 24 hours of the injury to optimize healing; however, if the wound is grossly contaminated, the procedure may be postponed for up to 2 weeks. This delay is critical to ensure that the risk of infection is minimized. The surgical approach involves exposing the tendon through a volar zigzag or lateral incision, with careful dissection of the surrounding soft tissues to protect vital neurovascular structures. Once the distal and proximal ends of the severed tendon are located, the proximal end is advanced distally and sutured to the distal end. In cases where less than a 1 cm distal stump remains, the tendon is advanced and sutured directly to the base of the distal phalanx. This procedure is essential for restoring function to the affected finger and ensuring proper healing of the tendon.
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The procedure described by CPT® Code 26370 is indicated for the following conditions:
The procedure for CPT® Code 26370 involves several critical steps to ensure successful repair of the FDP tendon:
After the completion of the procedure, post-operative care is crucial for recovery. Patients are typically monitored for signs of infection and proper healing of the surgical site. Rehabilitation may be initiated to restore function and strength to the affected finger, which may include physical therapy and gradual mobilization of the digit. The expected recovery time can vary based on the extent of the injury and the individual’s healing response. Follow-up appointments are essential to assess the healing process and to make any necessary adjustments to the rehabilitation plan.
| Short Descr | REPAIR FINGER/HAND TENDON | Medium Descr | RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN | Long Descr | Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 3 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | F1 | Left hand, second digit | F2 | Left hand, third digit | F3 | Left hand, fourth digit | F4 | Left hand, fifth digit | F5 | Right hand, thumb | F6 | Right hand, second digit | F7 | Right hand, third digit | F8 | Right hand, fourth digit | F9 | Right hand, fifth digit | FA | Left hand, thumb | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | T5 | Right foot, great toe | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| Pre-1990 | Added | Code added. |
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