Orthopedic Coding Alert

Question: Our patient had complete laceration zone 2 of middle and ring flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP). There was also a partial laceration of radial digital nerve middle finger and a complete laceration of ulnar digital nerve to both middle and ring fingers. The patient underwent the following procedures:

1. Zone 2 flexor tendon repair of FDP, FDS of middle finger. 

2. Zone 2 flexor tendon repair of FDP, FDS to ring finger. 

3. Repair partial laceration middle finger radial digital nerve and covering with Neuroflex tube. 

4. Micro repair of right middle finger ulnar digital nerve and right ring finger ulnar digital nerve.

Please advise how we can report these procedures.

Florida Subscriber

Answer: You report the tendon repair of FDP and FDS of middle finger with 26356 (Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath [e.g., no man’s land]; primary, without free graft, each tendon) x2. Similarly, you report the tendon repair of FDP and FDS in ring finger with 26356 x2. For partial laceration repair of middle finger radial digital nerve, you report 64910 (Nerve repair; with synthetic conduit or vein allograft [e.g., nerve tube], each nerve). For repair of right middle finger and right ring finger ulnar digital nerve, your report codes 64831 (Suture of digital nerve, hand or foot; 1 nerve) and +64832 (Suture of digital nerve, hand or foot; each additional digital nerve [List separately in addition to code for primary procedure]).