" . . . A small longitudinal split was created in the mid substance of the FCR tendon distally, adjacent to its insertion, and a 2-0 Prolene suture was used to secure the proximal edge of this split, to prevent proximal propagation and migration of the suspension. Then, the APL slip was weaved through this split, and while traction was held at the thumb and tension was held on the APL slip, it was doubled back and sutured to itself at its distal insertion, as well as to the dorsal periosteum of the first metacarpal, with 2-0 Prolene suture. . . . "
Does this support 26480 "Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon" ?
The CMC arthroplasty (25447) includes splitting the FCR. To me, it doesn't seem that the surgeon truly transferred/transplanted the APL. He pulled it through the split/loop he made in the FCR and then sutured it back. Surgeon requesting to bill both 25447 and 26480. There is no NCCI PTP edit but I think that's because 26480 isn't specified to the APL only.
Thoughts, please!
Does this support 26480 "Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon" ?
The CMC arthroplasty (25447) includes splitting the FCR. To me, it doesn't seem that the surgeon truly transferred/transplanted the APL. He pulled it through the split/loop he made in the FCR and then sutured it back. Surgeon requesting to bill both 25447 and 26480. There is no NCCI PTP edit but I think that's because 26480 isn't specified to the APL only.
Thoughts, please!