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The procedure described by CPT® Code 26390 involves the excision of a flexor tendon in the hand or finger, accompanied by the implantation of a synthetic rod. This procedure is typically indicated when a flexor tendon repair has either failed or has not been performed in a timely manner, necessitating a delayed flexor tendon grafting approach. The process is executed in two stages, with the first stage being the focus of this code. During this initial stage, a zigzag incision is made over the affected tendon to access the injured area. Careful dissection of the surrounding soft tissues is performed to protect vital neurovascular structures. The tendon sheath is then incised, allowing for the injured tendon to be meticulously dissected free from the surrounding tissue and subsequently excised. Following the removal of the damaged tendon, a synthetic rod is inserted along the entire length of the tendon sheath. This rod serves as a scaffold for the healing process, remaining in place for approximately 10 weeks while the tendon sheath heals around it. After this healing period, the second stage of the procedure, which involves the actual tendon grafting, can be performed under a different CPT® code. The careful execution of this procedure is crucial for restoring function and mobility to the affected hand or finger.
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The procedure described by CPT® Code 26390 is indicated for specific conditions related to the flexor tendon in the hand or finger. These indications include:
The procedure for CPT® Code 26390 involves several critical steps that are executed with precision to ensure successful outcomes. The steps are as follows:
After the completion of the procedure coded by CPT® 26390, the patient is expected to undergo a recovery period during which the synthetic rod remains in place for approximately 10 weeks. During this time, the tendon sheath heals around the rod, which is critical for the success of the subsequent tendon grafting procedure. Post-procedure care may include monitoring for signs of infection, managing pain, and ensuring that the surgical site is kept clean and dry. Patients may also be advised on activity restrictions to prevent undue stress on the healing tendon sheath. Follow-up appointments will be necessary to assess the healing process and to plan for the second stage of the procedure, which involves the actual tendon grafting.
| Short Descr | REVISE HAND/FINGER TENDON | Medium Descr | EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F | Long Descr | Excision flexor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod | 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 2 | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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 | 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 |
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| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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