Wiki Cpt 26676

Modesto, CA; Central Valley Chapter
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Today is my day for questions! Hope someone can shed some light.

Code 26676 states 'each joint' and I want to make sure I have this correct before I tell my physician to code anything additional.

The note states: I placed three of the 0.045-inch
K-wires to fix the fracture. One was placed through the base of the fifth
metacarpal into the hamate. The second was placed in the fourth metacarpal
base into the capitate and the third was directed from the fifth into the
fourth and into the third metacarpal base.

This looks like 3 joints to me; Am I totally off here? He is coding 26676 x 1 and I thinking 26676 x 3 for 3 joints.

If I am totally off I hope someone gets a good laugh at my 'goof'.



I do agree with you.

seems three different sites, has to be reported thrice.

as per the CDR : The physician manipulates a carpometacarpal dislocation (other than the thumb) to restore anatomical position and secures the bone with a wire. The physician determines the dislocated position of the bone. The bone is relocated to the correct anatomical position using external manipulation. The physician drills a wire through the carpometacarpal joint. The drill entry point is dressed and the hand is splinted..

I think the question is how many dislocated/fractured joints there were. If he's using 3 wires to fix one fracture, then I think he'd only bill the code 1x. If he's actually fixing 3 separate joints, then x3. Check his dx as to how which joint(s) was involved in the fx/dislocation & ask your doctor if unclear. Anyway, that's what I'd do. Have a good day!
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