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2025 CPT code 26450

Open tenotomy of a flexor tendon in the palm, for each tendon.

If a cast or splint is applied, it's included in the procedure and not billed separately. If another provider removes a cast applied by the surgeon who performed 26450, a separate cast removal code would be appropriate.

Modifiers can be applied to indicate specific circumstances. For example, modifier "-FA" through "-F9" could denote the specific finger treated.

Medical necessity is established by demonstrating the functional impairment caused by the shortened flexor tendon. Documentation should clearly support the need for surgical intervention to improve hand function, range of motion, and alleviate symptoms.

The physician is responsible for preparing the patient, administering anesthesia, performing the surgical procedure including incision, dissection, tendon release, hemostasis, and wound closure, and post-operative care.

In simple words: This procedure corrects a hand deformity by lengthening a shortened tendon in the palm. The surgeon makes a small cut, reaches the tendon, and lengthens it so the finger can straighten more fully. Each tendon that needs lengthening is billed separately.

This code describes a surgical procedure where the physician performs an open tenotomy, which is the surgical division of a flexor tendon in the palm. The procedure involves making an incision, dissecting through tissue to expose the tendon, and then incising the tendon to lengthen it, correcting a deformity. Hemostasis is achieved, and the wound is closed with sutures. One unit of this code is used for each flexor tendon in the palm that is treated.

Example 1: A patient with Dupuytren's contracture affecting multiple flexor tendons in the palm may require multiple units of 26450, one for each affected tendon undergoing open tenotomy., A patient with a congenital hand deformity causing a flexor tendon in the palm to be too short would benefit from 26450 to lengthen the tendon and improve hand function., A patient with a traumatic injury resulting in a contracted flexor tendon in the palm. This scenario may require open tenotomy, represented by 26450, to restore normal hand function.

Documentation should include details of the deformity, the specific tendon(s) involved, the surgical approach, intraoperative findings, and method of wound closure. Pre- and post-operative diagnoses, and any complications should also be documented.

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