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New to ortho coding?

  1. #1
    Default New to ortho coding?
    Medical Coding Books
    Can anyone advise on code 26600 can you bill this more than once on two separate fingers (f8 & f9) or can it only be one code since the description is stating "metacarpal"?

    Thanks for your help!!

    Phyllis D

  2. #2
    Talking
    If you read the descriptor in the cpt book, it does state each bone. So yes you can. If both the fractures require separate xrays and separate castings etc...we would charge out the two codes, but if it doesnt we stick to the one code.

  3. Default
    Yes, you can code for each Metacarpal fx, code 26600 with either RT or LT modifier, no f8 or f9, and 2 units. 26600 is not to be used for "finger" fractures. You can also bill for your fiberglass material. Mary

  4. #4
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    Columbia, MO
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    Metacarpal can be billed using the F modifiers because each metacarpal identifies to a unique finger there are 5 metacarpals in each normal hand. so yes if the code states metacarpal then it is for only one bone and you did the 4th and the 5th metacarpal on the right hand which is F8 and F9.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
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    Quote Originally Posted by mitchellde View Post
    Metacarpal can be billed using the F modifiers because each metacarpal identifies to a unique finger there are 5 metacarpals in each normal hand. so yes if the code states metacarpal then it is for only one bone and you did the 4th and the 5th metacarpal on the right hand which is F8 and F9.
    F modifiers are fore fingers only, same way as T modifiers are for toes. So the right way will be to use RT & LT modifiers for any bones except toes and finger.

  6. #6
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    a metacapal is a finger bone! the finger bones do not start at the apendage the start from the carpal bones. metatarsals are toe bones! you do not use LT and RT for metatcarpal you use RT and LT for carpal and tarsal bones but the metacarpals and metatarsal you have 10 of each. please get a hand and foot skeleton to verify this. From the hand dictionary:
    You have five metacarpal bones, one for each of your fingers.
    Last edited by mitchellde; 11-04-2011 at 11:11 AM.

    Debra A. Mitchell, MSPH, CPC-H

  7. #7
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    Quote Originally Posted by mitchellde View Post
    a metacapal is a finger bone! the finger bones do not start at the apendage the start from the carpal bones. metatarsals are toe bones! you do not use LT and RT for metatcarpal you use RT and LT for carpal and tarsal bones but the metacarpals and metatarsal you have 10 of each. please get a hand and foot skeleton to verify this. From the hand dictionary:
    You have five metacarpal bones, one for each of your fingers.
    There are 5 bones called metatarsals located between the proximal phalanges and the distal row of tarsal bones in the hindfoot: 1st, 2nd, 3rd, 4th and 5th metatarsals.

    You should not append toe modifiers (-TA through -T9) to CPT codes that classify metatarsal surgery because metatarsal bones are foot bones, they are not toe bones/phalanges.

    I would be happy to read any written material stating that phalanges include metatarsals & metacarpals. Can you send me a link?

  8. #8
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    Quote Originally Posted by arme2783 View Post
    There are 5 bones called metatarsals located between the proximal phalanges and the distal row of tarsal bones in the hindfoot: 1st, 2nd, 3rd, 4th and 5th metatarsals.

    You should not append toe modifiers (-TA through -T9) to CPT codes that classify metatarsal surgery because metatarsal bones are foot bones, they are not toe bones/phalanges.

    I would be happy to read any written material stating that phalanges include metatarsals & metacarpals. Can you send me a link?
    Go to any anatomy book. The phalange is the distal end of the finger, the finger bone goes from the tip to the wrist, you have 10 distinct metacarpal bones and 10 metatarsals these are fingers and toes, go look at any skeletal film

    Debra A. Mitchell, MSPH, CPC-H

  9. #9
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    Quote Originally Posted by mitchellde View Post
    Go to any anatomy book. The phalange is the distal end of the finger, the finger bone goes from the tip to the wrist, you have 10 distinct metacarpal bones and 10 metatarsals these are fingers and toes, go look at any skeletal film
    Just talked to my doctor, board certified hand surgeon. He confirmed that fingers do not start from the wrist, metacarpal bones are not fingers. I dont think it makes any difference to you, I just wanted to share this with others.

  10. #10
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    I am not sure how you presented the question to him and that would maybe be the reason the answer is the way it is. When you say fingers you are talking phalanges which are an extension of the metacarpal, but for the purpose of coding you do use the F modifiers for the metacarpal bones, it is all one thing. If you use only LT and RT for metacarpal procedures and the codes specifies each bone then you are leaving out numerous procedures and you do not use units with surgical procedures. So if you do not want to use the F modifiers then you can use the 59. I have coded many hand surgeries for the surgeon and the facility and have always used the F modifiers.
    It is all in how you present the information to the physician with respect to the answer you get.

    Debra A. Mitchell, MSPH, CPC-H

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