2025 CPT code 26641
Closed treatment of carpometacarpal dislocation, thumb, with manipulation.
Modifiers may be applicable to 26641 in certain situations, such as modifier 54 (Surgical Care Only) if the physician performs only the reduction and another provider manages the postoperative care. Modifier 76 (Repeat Procedure or Service by Same Physician) may be used if the same physician needs to perform a subsequent closed reduction due to re-dislocation.
Medical necessity for 26641 is established when a patient presents with a carpometacarpal dislocation of the thumb that is amenable to closed treatment without the need for open surgery or percutaneous fixation. Documentation supporting the instability or failed conservative management should be included.
After preparing the patient and administering anesthesia, if necessary, the physician manipulates the bones of the thumb's carpometacarpal joint back into their proper alignment. Imaging is used to confirm the correct positioning. A splint or cast is then applied to stabilize the joint and provide pain relief.
In simple words: The doctor will move the dislocated bones at the base of your thumb back into place without surgery. This is done by manipulating the bones from outside your skin. A splint or cast will then be applied.
This code represents the closed treatment of a carpometacarpal (CMC) dislocation of the thumb joint, involving manipulation to restore the joint to its normal anatomical position. This procedure is performed without making an incision into the joint. The application and removal of the first cast, splint, or traction device are included in the code.
Example 1: A patient presents with a dislocated thumb after falling. The physician performs a closed reduction of the carpometacarpal joint and applies a thumb spica cast., A basketball player dislocates his thumb during a game. The physician manipulates the joint back into place without needing an incision, and the patient's thumb is immobilized with a splint. , A patient suffers a dislocated thumb and initial reduction is unstable, requiring percutaneous pinning in addition to the closed manipulation. Code 26641 is still applicable for the initial manipulation component.
Documentation should include details of the dislocation, the manipulation procedure, confirmation of reduction through imaging (e.g., x-ray), and the type of immobilization applied (e.g., splint, cast). The medical record should also support the medical necessity for the procedure.
- Specialties:Orthopedic Surgery, Hand Surgery, Emergency Medicine
- Place of Service:Office, Hospital Inpatient/Outpatient, Emergency Room - Hospital, Ambulatory Surgical Center, Outpatient Hospital