Wiki 25310 vs. 26480

[KristinM522]

Hello all!

I am wondering what tendon transfer code you use for a CMC joint arthroplasty? I always thought we code from where the tendon is taken, so if Doc is harvesting the FCR tendon from the wrist/forearm we would code 25310. However, the doctor has a really old hand code book that has a 1 sentence line saying "AAOS has changed the coding from 25310 to 26480" from 2009..

I cannot find any recent advice from the AAOS but I am come across plenty of articles that suggest using one or the other, but to pick from the site of harvest.

Does anyone agree with 25310 and if so do you have any information from a credible source newer then 2009 that will back us up?

Thanks in advance for any help you can offer!

 

[Kelly_Josephine]

Hello all!

I am wondering what tendon transfer code you use for a CMC joint arthroplasty? I always thought we code from where the tendon is taken, so if Doc is harvesting the FCR tendon from the wrist/forearm we would code 25310. However, the doctor has a really old hand code book that has a 1 sentence line saying "AAOS has changed the coding from 25310 to 26480" from 2009..

I cannot find any recent advice from the AAOS but I am come across plenty of articles that suggest using one or the other, but to pick from the site of harvest.

Does anyone agree with 25310 and if so do you have any information from a credible source newer then 2009 that will back us up?

Thanks in advance for any help you can offer!

I'd really like to see everyone's thoughts here as well!

 

[Palmtoptiger]

Hi,

I was curious as well about the answer to your question. I did some research but i got an article from year 2005 saying that we need to code from where it was harvested.

Link: https://www.supercoder.com/coding-n...rect-cmc-arthroplasty-transplant-code-article

2013 link below doesn't specify if we base it from the site harvested or not. (page 27)

http://www.michiganasc.com/images/Session_2_-_Coding_for_Difficult_Tendon_Repairs_and_Transfers.pdf

Can't find any other source at this time.

Any other insights? Very much appreciated.

Thanks,

 

[Kelly_Josephine]

...I was curious as well about the answer to your question. I did some research but i got an article from year 2005 saying that we need to code from where it was harvested.

Link: https://www.supercoder.com/coding-n...rect-cmc-arthroplasty-transplant-code-article ...

That's all I could find as well - I submitted this as a dispute in an audit and am waiting to hear back. Will post if I can find any new citations.

 

[ptanksley51]

Coding Specialist

I have been coding for hand physicians for the last year or so and this is the one surgery where you do not bill from where the graft was harvested. This would be coded with 26480 using a 59 modifier.

 

[christinnagle]

Glad we're all seeing the same issues but sad that this issue still isn't resolved w/ solid guidance from AMA/CPT assist. I, too, had to double check myself AGAIN about this issue. So found an AAOS 2019 article for everyone's reference... https://www.aaos.org/AAOSNow/2019/Mar/Managing/managing01/ Don't forget to add -51 to the tendon harvest for these cases.