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Tendon lengthening is a surgical procedure aimed at correcting flexion or extension contractures in the upper arm or elbow. This condition occurs when the tendons become shortened, limiting the range of motion in the affected joint. The procedure involves making a skin incision over the elbow or upper arm to access the tendon of the muscle that is causing the contracture. A common technique used during this procedure is the Z-plasty incision, which allows for effective lengthening of the tendon. Once the tendon is identified, it is incised, and the surgeon checks the range of motion to ensure that the desired lengthening has been achieved. After the tendon has been appropriately lengthened, the overlying soft tissues and skin are meticulously closed in layers to promote proper healing. To maintain the new length of the tendon and support the joint during the recovery process, a cast or splint is applied. It is important to note that this CPT® code is reported separately for each tendon that is incised and lengthened, reflecting the specific nature of the surgical intervention performed.
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The procedure of tendon lengthening is indicated for specific conditions that result in flexion or extension contractures of the upper arm or elbow. These indications may include:
The tendon lengthening procedure involves several critical steps to ensure successful outcomes. Each step is designed to address the specific needs of the patient while ensuring the integrity of the surrounding structures.
Post-procedure care is critical for ensuring a successful recovery following tendon lengthening. Patients are typically monitored for any signs of complications, such as infection or excessive swelling. The application of a cast or splint is essential to maintain the tendon length and support the joint during the healing process. Patients may be advised on specific rehabilitation exercises to gradually restore range of motion and strength, although these should be initiated only under the guidance of a healthcare professional. Follow-up appointments are necessary to assess healing and adjust the rehabilitation plan as needed. The overall recovery time may vary depending on the extent of the procedure and the individual patient's healing response.
| Short Descr | TENDON LNGTH UPR A/E EA TDN | Medium Descr | TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON | Long Descr | Tendon lengthening, upper arm or elbow, each tendon | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 4 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| RT | Right side (used to identify procedures performed on the right side of the body) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | LT | Left side (used to identify procedures performed on the left side of the body) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | SG | Ambulatory surgical center (asc) facility service | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2023-01-01 | Note | Short description changed. |
| Pre-1990 | Added | Code added. |
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