LRTI - 25447 + 26480 or 26483? Free graft / spacer


Melrose, FL
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Can someone please look at the op report below and let me know what they think is supported? ASSH specifically states 26480 for tendon transfer INTO the CMC area, since for LRTI they state that the tendon transfer code is to be selected based on the recipient site. My question is about the "free graft" language possibly supporting 26483? Can someone please explain the spacer / free graft?

"The tourniquet was inflated to 250 mmHg. We made incision over the CMC joint of the thumb dissecting sharply
through the skin and bluntly through the subcutaneous tissue. We identified
the trapezium and removed it in a piecemeal fashion. At this point, we made a
separate incision proximally. We harvested the entire FCR tendon and reflected
it out distally. We made a bone tunnel through the first metacarpal and passed
that tendon through it and then sutured it back onto itself. Excess tendon was
then used as a free graft and sutured as a spacer and placed into position.
The dorsal capsule was then closed over that. We then closed the skin using
interrupted nylon. Tourniquet was deflated. The patient had brisk capillary
refill. Thumb spica splint was applied and the patient was transferred out to
recovery room in stable condition."
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