Orthopedic Coding Alert

Question: Our surgeon recently diagnosed and treated a left thumb accessory ossicle fracture. Which codes should we report for this service?

Arkansas Subscriber

Answer: An accessory ossicle is an extra bone or portion of bone that grows within your body. It can be an abnormal extension of an existing bone, or a small bony material that grows where it normally wouldn’t. It would be unusual for a surgeon to treat an accessory ossicle fracture. Instead, surgeons normally excise accessory ossicles.

If your surgeon did treat an accessory ossicle fracture on the thumb using fracture care, you should report the appropriate thumb fracture code (26600-26776). Remember, this would be very rare.

If the surgeon excised the ossicle, you should instead report 26230 (Partial excision [craterization, saucerization, or diaphysectomy] bone [e.g., osteomyelitis]; metacarpal) or another appropriate excision code based on the surgeon’s documentation.