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Opponensplasty is a surgical procedure aimed at restoring thumb abduction, particularly in patients who have experienced median nerve damage. This condition often results in a loss of function in the thumb, which is critical for grasping and pinching movements. The procedure involves various techniques, one of which includes the transfer of the hypothenar muscles, a group of three muscles located in the palm that primarily control the motion of the little finger. These muscles include the abductor digiti minimi, the flexor digiti minimi, and the opponens digiti minimi. By mobilizing and transferring these muscles to the thumb's muscles and tendons, the surgeon aims to re-establish the ability to abduct the thumb effectively. Other techniques for opponensplasty may involve the transfer of different tendons, such as the palmaris longus or superficialis tendon, each with its specific procedural steps and anatomical considerations. The choice of technique depends on the individual patient's condition and the extent of nerve damage, with the ultimate goal of improving hand function and quality of life.
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Opponensplasty is indicated for patients who have suffered from median nerve damage, leading to impaired thumb abduction. The procedure is particularly relevant for individuals experiencing significant functional limitations in hand movements, which can affect daily activities and overall quality of life. The following conditions may warrant the performance of opponensplasty:
The procedure of opponensplasty involves several critical steps to ensure the successful transfer of the hypothenar muscles to restore thumb abduction. The following outlines the procedural steps:
After the completion of the opponensplasty procedure, patients typically undergo a recovery period that may involve immobilization of the thumb to allow for proper healing of the transferred muscles. Physical therapy may be recommended to enhance rehabilitation and restore function gradually. Patients are monitored for any signs of complications, such as infection or improper healing, and follow-up appointments are scheduled to assess the success of the procedure and the restoration of thumb abduction. The overall recovery time can vary based on individual circumstances and adherence to post-operative care instructions.
| Short Descr | HAND TENDON/MUSCLE TRANSFER | Medium Descr | OPPONENSPLASTY HYPOTHENAR MUSC TR | Long Descr | Opponensplasty; hypothenar muscle transfer | 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 | 1 | 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). | 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) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| Pre-1990 | Added | Code added. |
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