2025 CPT code 26686
(Active) Effective Date: N/A Revision Date: N/A Surgery - Fracture and/or Dislocation Procedures on the Hand and Fingers Musculoskeletal System Feed
Open treatment of carpometacarpal dislocation (excluding thumb) involving complex, multiple, or delayed reduction.
Modifiers such as 50 (bilateral procedure), 51 (multiple procedures), 58 (staged procedure), 76 (repeat procedure) may be applicable depending on the circumstances. Consult the AMA CPT guidelines for appropriate modifier usage.
Medical necessity for CPT 26686 is established when conservative treatment (closed reduction) fails to achieve adequate reduction of the carpometacarpal dislocation, or when the dislocation is deemed complex, multiple or delayed.
The orthopedic surgeon or hand surgeon is primarily responsible. Pre-operative assessment, surgical procedure, post-operative care, and follow up are all part of the clinical responsibility.
- Musculoskeletal System
- Surgical Procedures on the Hand and Fingers > Fracture and/or Dislocation Procedures on the Hand and Fingers
In simple words: This code describes surgery to fix a dislocated wrist bone (not the thumb).The surgery is for complicated cases, such as multiple dislocations or a delay in treatment after the injury. The doctor makes an incision, realigns the bones, and closes the wound. A splint or brace is applied.
This CPT code encompasses the open surgical treatment of a carpometacarpal (CMC) joint dislocation, excluding the thumb. The procedure addresses situations characterized by complex dislocations, multiple dislocations, or a delay between injury and surgical intervention.It involves surgical opening of the affected joint to achieve reduction (realignment) of the dislocated bones. The complexity might necessitate excision of adhesions or multiple reduction attempts within the same procedure.Post-reduction, the surgical site is irrigated, hemostasis is achieved, and the incision is closed.Immobilization is typically achieved with a splint or brace.
Example 1: A 35-year-old male sustains a complex carpometacarpal dislocation of the little finger during a sports injury. After a delay of 2 weeks, due to initial conservative treatment failure, open reduction with internal fixation is performed using CPT code 26686., A 40-year-old female experiences a fall and sustains multiple carpometacarpal dislocations in her right hand, excluding the thumb. Open reduction is required, necessitating the use of CPT code 26686., A 22-year-old male sustains a carpometacarpal dislocation of the ring finger during a motor vehicle accident.Initial attempts at closed reduction fail and, therefore, an open reduction and internal fixation are performed using CPT code 26686.
Detailed operative report describing the surgical approach, steps taken to reduce the dislocation, any internal fixation used, imaging results pre- and post-operative, and the post-operative management plan.Preoperative and postoperative radiographic imaging is crucial.Patient's history, physical examination findings and other relevant medical records should also be documented.
** Accurate documentation of the complexity of the dislocation is critical for appropriate code selection and reimbursement.Preoperative and postoperative imaging should be part of the medical record.
- Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
- RVU: This information is not available in the provided text and would require consultation of a current fee schedule.
- Global Days : The global period for this procedure will vary depending on payer and local guidelines; consult the specific payer's guidelines for details.
- Payment Status: Active
- Modifier TC rule: The provided text does not contain information about the use of TC modifiers for this code.
- Fee Schedule : This information is not available in the provided text and would require consultation of a historical fee schedule.
- Specialties:Orthopedic Surgery, Hand Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital