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Capsulodesis is a surgical procedure aimed at correcting deformities in the metacarpophalangeal (MCP) joint of the finger, specifically addressing issues related to flexion or extension. This procedure is particularly relevant for patients who experience functional limitations due to these deformities. The surgery involves making an incision over the affected MCP joint, allowing the surgeon to access the underlying structures. The flexor pollicis longus tendon is exposed, and a portion of its tendon sheath is excised to facilitate the procedure. The surgical approach includes retracting the tendon to expose the volar plate, which is a critical structure in the MCP joint. The volar plate is then incised at its proximal and lateral attachments, effectively dividing the intrinsic muscles while preserving the distal attachment. This careful dissection is essential for repositioning the volar plate in a manner that optimizes joint function. The finger is positioned in a slightly flexed state to enhance its functional capabilities post-surgery. To secure the volar plate against the metacarpal neck, a Kirschner wire is drilled into the bone, ensuring that the finger remains in the desired position during the healing process. This procedure is coded as CPT® 26517 when performed on two fingers, distinguishing it from similar procedures coded under 26516 for one finger and 26518 for three or four fingers.
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The procedure of capsulodesis is indicated for patients presenting with specific deformities of the metacarpophalangeal (MCP) joint. These indications include:
The capsulodesis procedure involves several critical steps to ensure effective correction of the MCP joint deformity. The steps are as follows:
After the capsulodesis procedure, patients can expect specific post-operative care and recovery considerations. It is essential to monitor the surgical site for any signs of infection or complications. Patients may be advised to keep the hand elevated to reduce swelling and to follow specific instructions regarding movement and rehabilitation exercises. The recovery period will vary depending on individual healing rates, but patients should anticipate a gradual return to normal function as the joint heals. Follow-up appointments will be necessary to assess the healing process and to make any adjustments to the rehabilitation plan as needed.
| Short Descr | FUSION OF KNUCKLE JOINTS | Medium Descr | CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS | Long Descr | Capsulodesis, metacarpophalangeal joint; 2 digits | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | 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) | 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 | 1 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
| 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). | 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. | 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 | F3 | Left hand, fourth digit | F4 | Left hand, fifth digit | F7 | Right hand, third digit | F8 | Right hand, fourth 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 |
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| 2009-01-01 | Changed | Code description changed |
| Pre-1990 | Added | Code added. |
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