AAPC - Back to school
Results 1 to 3 of 3

Thread: Resection of metacarpal heads and arthroplasties

  1. #1
    Join Date
    Apr 2007

    Default Resection of metacarpal heads and arthroplasties

    AAPC: Back to School
    I need help on this report please! So far I am not sure about the metacarpal head resection - the closest I could come is 26230 x4???
    Then for the arthroplasties, maybe 26531 x4???
    For Dupuytren's a 26123? or is some of it included in some?

    NAME OF OPERATION: 1. Open palm release of Dupuytren’s.
    2. Resection of metacarpal heads and flexible implant arthroplasties, index through small fingers.

    INDICATIONS: This gentleman has history of Dupuytren’s and rheumatoid arthritis and is here for the above-listed procedures.

    PROCEDURE: The patient was taken to the operating room. After adequate general anesthesia was obtained, the left arm was prepped with Betadine scrub and solution and draped in the usual sterile fashion. A transverse incision was made in the palm and the pretendinous cords were released. The digital nerves were located and protected. The fingers were manipulated into extension.

    Two longitudinal incisions were made, one in between the index and middle fingers and the second in between the ring and small fingers. Dissection was carried down through the subcutaneous tissues to the extensor tendons. All were subluxed in the ulnar gutters. All ulnar intrinsics were released including the abductor digiti quinti to the small finger. The metacarpal heads were resected with the oscillating saw and the bases of the proximal phalanges flattened as well. The canals were prepared sequentially with reamers and broaches.
    The index, middle, ring, and small finger sizes selected were 20, 30, 20, and 10 with the small finger having a reversed implant. Holes were made in the dorsoradial corners of the metacarpal necks and 2-0 suture placed for ligament reattachment. The finger could be placed to about 30 degrees short of full extension without rebound. The extensor tendons were centralized over the metacarpal heads radially by imbricating the lax sagittal band tissue. The skin was then closed with interrupted 5-0 nylon on the dorsal aspect of the hand. The palmar wound was left open.

  2. #2
    Join Date
    Apr 2007


    for the open palm dupuytren's release it is definetly 26040 as it was of the palm only and i do not see that a graft was done, if a graft was done then use 26121. As for the resection of the metacarpal that code is 26250 x4
    the arthroplasty w/ implant im not sure of as the joint was not specified.
    hope this helps good luck
    Last edited by michellelgrd; 09-01-2009 at 08:52 AM.

  3. #3
    Join Date
    Apr 2007


    Thanks for your reply Michelle!

    I was confused with the releases of the fingers, but I have decided to go with 26045 (instead of 26123), since it was an open procedure (26040 is percutaneous).

    I don't think the 26250 is correct, because it was only the metatarsal HEADs, and not a radical resection (for a tumor). I think I am going to use 26531 for the arthroplasties, and I researched a little bit more and found out that it includes "bony resection and preparation of bone for implant insertion", according to CodeX's GSD.

    Thanks again!

Similar Threads

  1. Displacement Metacarpal
    By LLRodgers in forum Orthopaedics
    Replies: 0
    Last Post: 05-07-2015, 07:24 AM
  2. question regarding total knee arthroplasties
    By kc-george in forum Orthopaedics
    Replies: 0
    Last Post: 03-13-2014, 06:56 AM
  3. Spines and Heads
    By j.berkshire in forum Neurology/Neurosurgery
    Replies: 0
    Last Post: 05-18-2012, 11:41 AM
  4. confusion on hip arthroplasties
    By scooter1 in forum Orthopaedics
    Replies: 1
    Last Post: 12-19-2011, 12:40 PM
  5. metacarpal injections
    By astephens in forum Orthopaedics
    Replies: 2
    Last Post: 02-12-2009, 03:13 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.