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Orthopedic Coding Alert

Reader Question:

Be Discrete in Tendon Transfer, Lengthening or Shortening

Published on Mon Aug 13, 2012

Question: Can we report codes 26498 (Transfer of tendon to restore intrinsic function; all 4 fingers) and 25280 (Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon) for the following procedure that our surgeon does?

"A longitudinal incision was made in distal third of forearm. The flexor digitorum superficialis tendons to the index, long, ring, and small fingers were identified and transected just distal to the musculotendinous junction. The flexor digitorum profundus tendons to index, long, ring, and small fingers identified and transected distally towards the distal part of the incision. Proximal stump of profundus tendons were sutured to distal stumps of superficialis tendons. There was marked contracture of the IP joint of thumb and it was elected to proceed with fractional lengthening of flexor pollicis longus tendon. Flexor pollicis longus tendon was identified and transected a few centimeters proximal to musculotendinous junction. Thumb IP joint was passively extended and a gap of 1.5 cm was created between the ends of the tendon."

North Carolina Subscriber

Answer: You will only report 26498 for each tendon for all 4 fingers. Remember the code applies to transfer of tendon in all four fingers and cutting and suturing of tendons are intrinsic to the transfer. However, on the thumb, your surgeon was doing a lengthening of the tendon. So for the thumb you report 25280 only.

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