Orthopedic Coding Alert

Question: How do I code for an open reduction internal fixation of base proximal phalanx fracture? The only codes I could find involved either the shaft or the distal phalanx but not the base. The metacarpophalangeal and the interphalangeal joints were not involved.

Lorraine Anderson
Lincoln, Neb.

Answer: The appropriate guidelines of CPT procedural coding indicate to code the procedure or service with the most accurate CPT code that describes the procedure performed or service provided, says Catherine Brink, CMM, CPC, president of Healthcare Resource Management Inc., a practice management and reimbursement consulting firm based in Spring Lake, N.J.

According to the current CPT manual, code 26735 should be used for an open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with or without internal or external fixation, each. This code would be used for an open treatment of the shaft of the phalanx, for open treatment of the proximal phalanx and for open treatment of the middle phalanx, finger or thumb. Code 26735 would be appropriate for an open reduction and internal fixation of the base of the proximal phalanx to treat a fracture of the base of the proximal phalanx.