Hit the Target With Your Tendon Sheath Surgical Coding
Question: I’m having trouble choosing between 26055 and 26145 for a procedure. The patient presented with a locked ring finger on their right hand. The surgeon made an incision and removed a small amount of inflamed tenosynovium around the swollen flexor tendon. Can you explain the differences between the two codes? Revenue Cycle Insider Subscriber Answer: Certainly! Use 26055 (Tendon sheath incision (eg, for trigger finger)) when the surgeon treats the patient’s trigger finger by incising the tendon sheath of the finger. In your case, this is the appropriate code for the procedure. Trigger finger, which is also known as stenosing tenosynovitis, occurs when the patient’s finger remains fixed in a bent position. The patient may experience pain when they try to extend or bend the finger. During the procedure, the surgeon makes a cut into the finger, and they might remove a portion of the inflamed tendon sheath to relieve the patient’s condition. Phrases in the documentation may include: On the other hand, you’ll assign 26145 (Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon) when the surgeon performs a tenosynovectomy. During this procedure, the physician removes the synovial membrane from the affected fingers or palm flexor tendon sheaths. The synovial membrane may be diseased, which can be the cause of the patient’s pain. The following phrases in the documentation can be indicative of 26145: Mike Shaughnessy, BA, CPC, Production Editor, AAPC
