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2025 CPT code 26685

Open treatment of carpometacarpal dislocation, excluding the thumb; includes internal fixation if performed, per joint.

Consult the official CPT manual for the most up-to-date coding guidelines for this procedure.Pay close attention to the inclusion/exclusion criteria.

Modifiers may be applied as appropriate (e.g., modifier 51 for multiple procedures, modifier 76 for a repeat procedure by the same physician).

Medical necessity is established when the dislocation significantly impairs the patient's hand function and conservative management has failed.Documentation should show attempts at non-operative treatment and the rationale for the surgical intervention.

The surgeon is responsible for the preoperative evaluation, surgical procedure, postoperative care, and follow-up appointments. Anesthesia may be provided by an anesthesiologist or the surgeon (modifier 47). The surgeon may also utilize the services of other qualified healthcare professionals.

IMPORTANT Code 26686 is used for complex, multiple, or delayed reductions of carpometacarpal dislocations (excluding the thumb).

In simple words: This code covers surgery to fix a dislocated joint in the wrist (excluding the thumb). The doctor makes an incision, puts the bones back in place, and may use metal plates or screws to hold them while they heal. This code is for each joint that needs to be fixed.

This CPT code encompasses the open surgical treatment of a dislocated carpometacarpal (CMC) joint, excluding the thumb.The procedure involves an incision to access the joint, reduction of the dislocation, and optional internal fixation (e.g., plates, screws) to stabilize the joint.The code is reported per joint treated.Appreciable vessel exploration or neuroplasty would be billed separately.

Example 1: A patient presents with a traumatic carpometacarpal dislocation of the fourth finger, requiring open reduction and internal fixation with a small plate and screws. Code 26685 is reported., A patient sustains a carpometacarpal dislocation of the third finger during a fall.Open reduction is performed with internal fixation using Kirschner wires. Code 26685 is used, and the use of Kirschner wires is included in the code description., A patient with a chronic, irreducible carpometacarpal dislocation of the second finger undergoes open reduction and internal fixation. Code 26685 is reported. If a complex reduction was required, code 26686 might be more appropriate.

* Preoperative diagnosis with supporting imaging (e.g., X-ray) showing the dislocation.* Operative report detailing the surgical technique, including the type of internal fixation used (if any).* Postoperative imaging (e.g., X-ray) demonstrating successful reduction and stable fixation.* Anesthesia records if anesthesia services were provided by a separate provider.

** This code applies to carpometacarpal dislocations in fingers other than the thumb.The code may be billed multiple times if multiple joints are treated during the same encounter.

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