Orthopedic Coding Alert

Question: Our surgeon removed half of the sublimis in the patient’s finger in September 2012. The patient returned with problems and our surgeon then did a right index finger excision of the ulnar sublimis as well as scar excision and tensoynovectomy. The other procedures included a small finger A-1 pulley release with tenosynovectomy of the small finger flexors. Please advise on reporting this case.

Florida Subscriber

Answer: You report 26180 (Excision of tendon, finger, flexor or extensor, each tendon) for the excision of the sublimis. This has a global period of 90 days. The patient here is returning within the global period limits. Since your surgeon is not excising the complete sublimis, this is a reduced procedure. You append modifier 52 (Reduced services) to 26180. Another modifier you can append is modifier 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). For the trigger finger (A-1 pulley release), you report code 26055 (Tendon sheath incision [e.g., for trigger finger]) and append modifier 79 (Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period).