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The procedure described by CPT® Code 26483 involves the transfer or transplantation of a tendon specifically in the carpometacarpal area or the dorsum of the hand. This surgical intervention is typically performed to restore functionality that may have been compromised due to traumatic injuries affecting the nerve, tendon, or muscle. In some cases, the loss of function may also arise from conditions such as rheumatoid arthritis or gouty arthritis. The primary goal of this procedure is to re-establish the normal movement and strength of the hand by relocating a tendon from one area to another. The process begins with a longitudinal incision over the donor tendon, allowing the surgeon to expose and free the tendon from its attachments. This careful dissection is crucial to ensure that the tendon can be securely attached to the recipient site. The procedure may also involve harvesting the tendon along with a strip of periosteum to enhance the graft's stability. Additionally, muscle may be released from its fascial attachments to provide the donor tendon with maximum mobility and length necessary for effective transfer. A second incision is made at the recipient site, where the donor tendon will be anchored. The tendon is then routed to this site and temporarily secured with sutures. To ensure proper function, a neuromuscular stimulator is employed to test the donor tendon, allowing for adjustments in tension as needed before finalizing the attachment. After the surgical wounds are closed, immobilization of the wrist and/or hand is implemented to facilitate healing. It is important to note that CPT® Code 26483 is specifically used when a tendon graft is required to achieve the desired length, while CPT® Code 26480 is applicable for tendon transfers that do not involve grafting.
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The procedure described by CPT® Code 26483 is indicated for the following conditions:
The procedure for tendon transfer or transplantation as outlined in CPT® Code 26483 involves several critical steps:
After the tendon transfer or transplantation procedure, patients can expect a period of recovery that may involve immobilization of the wrist and/or hand to ensure proper healing. The immobilization is crucial to protect the surgical site and allow the tendon to integrate effectively with the surrounding tissues. Patients may also require follow-up appointments to monitor healing progress and assess the functionality of the transferred tendon. Rehabilitation exercises may be introduced gradually to restore movement and strength, but these should be guided by a healthcare professional to avoid complications. It is important for patients to adhere to post-operative care instructions to optimize recovery outcomes.
| Short Descr | TRANSPLANT/GRAFT HAND TENDON | Medium Descr | TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT | Long Descr | Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; with free tendon graft (includes obtaining graft), 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) | 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 | 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 | 4 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| RT | Right side (used to identify procedures performed on the right side of the body) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | LT | Left side (used to identify procedures performed on the left side of the body) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | F1 | Left hand, second digit | F2 | Left hand, third digit | F3 | Left hand, fourth 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 | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Medium description changed. |
| Pre-1990 | Added | Code added. |
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