Radial Sagittal Band Reconstruction

[adunlap23]

I have read that many people use 26437 for radial sagittal band repair. However, the following op note seems to involve much more complex work.

The op report states:

"I identified the extensor tendon. It was completely subluxed in an ulnar direction. It was actively snapping and popping. I incised the contracted ulnar sagittal band to mobilize the tendon and I mobilized it over the top of the MP joint. I incised the juncture between the fourth and fifth digits to centralize the tendon.

I then took a distally based slip of the EDC tendon and I transected this proximally. I then looped this onto the tendon and with a right angle snap, I placed this through collateral ligament and portion of the capsule. I then sewed this back on itself with 3 Pulvertaft weaves with 3-0 Ethibond. This resulted in excellent stability of the tendon..."

Would it be appropriate to report 26437 with 25312 for this procedure? Any help will be appreciated!

Also, the DX is Sagittal Band Rupture.

 

[adunlap23]

I have read that many people use 26437 for radial sagittal band repair. However, the following op note seems to involve much more complex work.

The op report states:

"I identified the extensor tendon. It was completely subluxed in an ulnar direction. It was actively snapping and popping. I incised the contracted ulnar sagittal band to mobilize the tendon and I mobilized it over the top of the MP joint. I incised the juncture between the fourth and fifth digits to centralize the tendon.

I then took a distally based slip of the EDC tendon and I transected this proximally. I then looped this onto the tendon and with a right angle snap, I placed this through collateral ligament and portion of the capsule. I then sewed this back on itself with 3 Pulvertaft weaves with 3-0 Ethibond. This resulted in excellent stability of the tendon..."

Would it be appropriate to report 26437 with 25312 for this procedure? Any help will be appreciated!

Also, the DX is Sagittal Band Rupture.

Another option I have considered is 26480 for tendon transfer at the dorsum area of the hand. 26437 bundles with this code, so I would report it by itself.
Seriously, anybody's opinion would help me feel better about which code to choose. I always second guess my own opinion.