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2025 CPT code 26556

Transfer of a free toe joint with microvascular anastomosis.

Follow all CPT coding guidelines, especially those related to surgical procedures, microvascular anastomosis, and bone grafting.Consult official coding manuals for the most current guidance.

Modifiers may be applicable depending on the circumstances of the procedure. For example, modifier 51 (multiple procedures) may be used if additional procedures are performed during the same session. Refer to the current CPT manual for modifier usage guidelines.

Medical necessity is established by the significant functional impairment of the affected finger joint due to trauma or congenital condition. The procedure is considered medically necessary when other less invasive options have failed or are not appropriate.

The clinical responsibility includes pre-operative planning, surgical execution of the toe harvest and finger joint preparation (often requiring two surgical teams), microvascular anastomosis, bone grafting, and post-operative care.

IMPORTANT:Do not report code 69990 in addition to code 26556.For great toe-to-hand transfer, use 20973.

In simple words: The surgeon moves a toe joint to replace a damaged finger joint. This complex surgery involves connecting the toe's blood vessels and nerves to the hand, using a bone graft to secure the new joint.

This procedure involves the transfer of a free toe joint to replace a finger joint, typically due to trauma or congenital deformity.It includes harvesting the toe with its associated blood vessels, nerves, bones, and tendons, followed by transplantation to the hand using microsurgical techniques and a bone graft for fixation. The donor site is closed, often with a skin graft.

Example 1: A patient sustains a severe crush injury to their index finger resulting in the loss of the proximal interphalangeal joint. A free toe-to-hand transfer is performed using 26556., A patient is born with a congenital deformity of the thumb, making it non-functional.A second toe is transferred to replace the thumb using 26556., A patient suffers a severe laceration to their ring finger, resulting in significant joint damage. A free toe joint transfer is performed to restore function using code 26556.

Detailed operative report, including specifics of the toe harvested, microvascular anastomosis details, type of bone graft used, and images (pre- and post-operative).Patient history, including details of the injury or congenital condition necessitating the procedure, should also be documented.

** This procedure is highly complex and requires specialized surgical expertise.Accurate coding requires detailed documentation of all aspects of the procedure.

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