2025 CPT code 26442

Tenolysis, flexor tendon; palm AND finger, each tendon.

Code 26442 should be reported once for each tendon undergoing tenolysis.If multiple flexor tendons in the same finger and palm are released, the code is reported for each tendon. If the procedure is performed on multiple digits, the appropriate code should be appended with a finger modifier.

Modifiers may be applicable in certain situations, such as if the procedure is significantly more complex than usual (modifier 22), or if only part of the service was provided (modifier 52 or 53).

Medical necessity for 26442 should be established by documenting the functional limitations caused by the tendon adhesions, such as restricted range of motion, pain, or interference with daily activities. Conservative treatments attempted prior to surgery, such as physical therapy, should also be noted.

The physician is responsible for the complete surgical procedure, from the initial incision and identification of the affected tendon to the removal of adhesions and closure of the wound. They must ensure proper surgical technique to minimize complications and restore optimal tendon function.

IMPORTANT For tenolysis of a flexor tendon in either the palm OR finger, use 26440. For tenolysis of an extensor tendon, use 26445.

In simple words: This procedure frees up a stuck tendon in your palm and finger.The tendon gets stuck because of scar tissue that forms after an injury or surgery. The surgeon makes a small cut, finds the tendon, and removes the scar tissue so the tendon can move smoothly again.

This code describes a surgical procedure where the physician releases a flexor tendon in both the palm and the same finger from adhesions. Adhesions are fibrous bands that can form between tissues, often after injury or surgery, restricting tendon movement. The procedure involves making an incision, dissecting the tissue, and meticulously breaking down the adhesions to restore free movement of the tendon.

Example 1: A patient previously had a flexor tendon repair in their index finger and palm. They now experience limited finger movement due to adhesions. The surgeon performs tenolysis using code 26442 to release the tendon in both areas., A patient with Dupuytren's contracture affecting a finger and the palm undergoes tenolysis to release the affected flexor tendon and improve finger mobility. The procedure involves releasing the tendon in both the palm and finger, thus 26442 is used., Following a traumatic hand injury, a patient develops restricted movement in their thumb due to adhesions around the flexor tendon in the palm and thumb. Code 26442 would be used if the procedure extended from the thumb into the palm.

Documentation should include the operative report detailing the surgical approach, the extent of adhesions, the specific tendon released, and any complications encountered. Pre- and postoperative range of motion assessments and any imaging studies used should also be documented.

** It's essential to ensure accurate measurement and documentation of the location and size of the affected tendon(s) to support the use of code 26442. It's crucial to differentiate procedures done on the palm OR finger (26440) from those on the palm AND finger (26442) to avoid inaccurate coding. Remember to check NCCI edits for any specific code pairing restrictions.

  • Specialties:Hand surgery, orthopedics, plastic surgery.
  • Place of Service:Ambulatory Surgical Center, Hospital Outpatient, Inpatient Hospital.
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