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Official Description

Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each joint

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Reconstruction of the collateral ligament of the interphalangeal (IP) joint is a surgical procedure aimed at repairing damage to the ligament that stabilizes the joint. This procedure is typically indicated following a traumatic injury, such as a laceration or rupture, which can compromise the joint's stability and function. The collateral ligaments are essential for maintaining the integrity of the IP joint during movement, and their reconstruction is crucial for restoring normal joint mechanics. In cases where an open wound is present, the surgical approach involves exploring the wound, removing any devitalized tissue, and clearing away foreign materials to prepare the site for reconstruction. For closed injuries, a dorsal incision is made over the affected joint to access the injured ligament. The surgeon evaluates the extent of the injury to determine the appropriate course of action. If a graft is necessary, an incision is made at the site where the tendon or fascial graft will be harvested. The graft is then meticulously attached to the remaining ligament or bony structures using sutures or bone anchors, ensuring proper tension and alignment. Finally, the surgical site is closed in layers to promote optimal healing and recovery.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Reconstruction of the collateral ligament of the interphalangeal joint is performed for specific indications related to joint stability and function. The following conditions may warrant this surgical intervention:

  • Traumatic Injury A laceration or rupture of the collateral ligament that compromises the stability of the interphalangeal joint.
  • Joint Instability Symptoms of instability in the IP joint due to ligament damage, which may affect the patient's ability to perform daily activities.
  • Chronic Pain Persistent pain in the joint area resulting from ligament injury that does not respond to conservative treatment measures.

2. Procedure

The procedure for reconstructing the collateral ligament of the interphalangeal joint involves several critical steps to ensure successful repair and restoration of joint function. Each step is detailed as follows:

  • Step 1: Wound Exploration If an open wound is present, the surgeon begins by exploring the wound site. This involves assessing the extent of the injury, debriding any devitalized tissue, and removing foreign materials to prepare the area for reconstruction.
  • Step 2: Incision for Closed Injury In cases of closed injuries, a dorsal incision is made over the affected interphalangeal joint. This incision allows access to the injured collateral ligament for evaluation and repair.
  • Step 3: Exposure and Evaluation The injured collateral ligament is carefully exposed, and the surgeon evaluates the extent of the injury. This assessment is crucial for determining the appropriate reconstruction technique.
  • Step 4: Graft Harvesting If a graft is required, an additional incision is made at the site where the tendon or fascial graft will be harvested. The surgeon excises the necessary length of tendon or fascia to be used in the reconstruction.
  • Step 5: Graft Attachment The harvested graft is then attached to the remnants of the ligament or to bony structures using sutures or bone anchors. This step is vital for ensuring the stability and functionality of the joint post-reconstruction.
  • Step 6: Range of Motion Evaluation After the graft is secured, the surgeon evaluates the range of motion of the joint and adjusts the tension of the graft as needed to ensure optimal function.
  • Step 7: Wound Closure Finally, the surgical wound is closed in layers to promote healing and minimize complications. Proper closure techniques are essential for recovery and the prevention of infection.

3. Post-Procedure

Post-procedure care following the reconstruction of the collateral ligament of the interphalangeal joint is essential for recovery. Patients are typically monitored for any signs of complications, such as infection or excessive swelling. Rehabilitation may include physical therapy to restore range of motion and strength in the joint. Patients are advised on activity restrictions to prevent undue stress on the repaired ligament during the initial healing phase. Follow-up appointments are necessary to assess the healing process and make any adjustments to the rehabilitation plan as needed. The expected recovery time may vary based on the extent of the injury and the individual patient's healing response.

Short Descr RECONSTRUCT FINGER JOINT
Medium Descr RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT
Long Descr Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each joint
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 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 4
CCS Clinical Classification 162 - Other OR therapeutic procedures on joints
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.
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).
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
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
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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