Does CPT 26541 fit the following...
The physician performs a primary repair on a collateral ligament of a metacarpophalangeal joint, possibly using a graft or advancement. The physician incises the overlying the skin and dissects to the MP joint. In 26540, the ligament is repaired with sutures. In 26541, a palmaris longus tendon or fascial graft is obtained. The graft is sutured into place. In 26542, an adductor tendon is advanced and sutured into place to stabilize the joint. The incision is sutured in layers.

Procedure:The left upper extremity was prepped and draped under sterile fashion. After exsanguination, the tourniquet was inflated to 150 mmHg. A 0.045 K- wire was inserted from the first to the second metacarpal. Two small incision were made over the wire and the superficial radial never was visualized over the dorsum of the thumb. This was protected.

The cannulated drill was then passed over the guidewire and the nitino looped wire was then passed inside of the cannulated drill. The mini TightRope from arthrex was then passed through and was then secured. The thunb was then distracted and reduced while the tightrope was being securded down. Over tightening was avoided by visualizing the small remianing space between the joint of the first to the second intermetacarpal space.

The ligament reconstruction was then secured with 6 additional half hichhs on top of th tightrop system. The lead suture was then removed and the skin was closed with 5-0 monocryl in interrupted simple fashion. Xeroform was applied. The patient was placed in thumb spica. splint. The tourniquet5 was released at 23 min.