Q&A: CPT coding for a closed treatment of a metacarpal fracture, with manipulation
JustCoding News: Inpatient, October 28, 2009
Want to receive articles like this one in your inbox? Subscribe to JustCoding News: Inpatient!
QUESTION: What code(s) should we report for the following procedure: Closed reduction, percutaneous pinning of the left fifth metacarpal base fracture?
Once general endotracheal anesthesia was achieved, the left upper extremity was manipulated under fluoroscopy to show a mobile fracture that was reducible with traction and manual pressure.
A 0.045 K-wire was then placed on the direct ulnar aspect of the fifth metacarpal base. Fluoroscopy was used to confirm adequate positioning at the base of the fifth metacarpal. The K-wire was then advanced into the fracture fragment into the third and fourth metacarpal base. A second K-wire was then placed approximately 1 cm distal and parallel to the previous K-wire into the fifth and fourth metacarpal. Fluoroscopy was used to confirm adequate reduction of the fifth carpometacarpal joint space and proper placement of K-wire pins. The K-wires were then cut at the level of the skin and buried underneath the skin.
Is CPT code 26605 (Closed treatment of metacarpal fracture, single; with manipulation, each bone) the correct code for this case?
ANSWER: From the notes you provided, I would agree that it would be correct to report CPT code 26605 for this procedure. In addition, I would report CPT code 26608 (Percutaneous skeletal fixation of metacarpal fracture, each bone) because the physician performed percutaneous fixation as well.
Editor’s note: Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CHA, of Safian Communications Services in Orlando, FL, answered this question. She is a senior assistant professor who teaches medical billing and insurance coding at Herzing University Online in Milwaukee, WI. E-mail her at ssafian@embarqmail.com.
This answer was provided based on limited information submitted to JustCoding.com. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.
Want to receive articles like this one in your inbox? Subscribe to JustCoding News: Inpatient!
Related Products
Most Popular
- Articles
-
- Joint Commission creates new Sentinel Event Alert for violence against healthcare workers
- Practice the six rights of medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Differentiate between types of wound debridement
- Don’t forget the three checks in medication administration
- OB services: Coding inside and outside of the package
- Q/A: Correctly determining billing units for drugs
- Complications from immobility by body system
- Avoid Eyewash-Related Regulatory Compliance Issues
- Coding tip: Be aware of primary versus secondary neoplasms
- E-mailed
-
- Joint Commission creates new Sentinel Event Alert for violence against healthcare workers
- Joint Commission now allows partially-used oxygen canisters in 'full' rack
- Dig into the details of wound care documentation
- Initial vs. subsequent. New vs. established. Will it be an issue?
- Examine documentation for clinical indicators that provide context for MCCs
- Do not append modifier -52 to procedures involving equipment failure
- Differentiate between types of wound debridement
- Data gathering/reporting: One CDI specialist shares her hospital's methodology
- Communication strategies for nurse leaders
- CMS and Joint Commission clarify door-closing devices standards
- Searched