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The CPT® Code 25927 refers to a surgical procedure known as transmetacarpal amputation. This procedure involves the complete removal of the fingers from the hand, including the bones that constitute the fingers. The term 'transmetacarpal' indicates that the amputation occurs at the level of the metacarpal bones, which are the long bones in the hand that connect the wrist to the fingers. This type of amputation is typically performed in cases where there is severe trauma, infection, or other medical conditions that necessitate the removal of the fingers to preserve the overall health of the hand or to prevent further complications. It is important to note that this procedure results in the loss of the fingers, which can significantly impact hand function and may require subsequent rehabilitation or prosthetic fitting. Additionally, if the physician needs to revisit the surgical site for further treatment, such as applying a more permanent closure or removing excess scar tissue, different CPT codes (25929 or 25931) should be utilized as specified in the coding guidelines.
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The indications for performing a transmetacarpal amputation (CPT® Code 25927) typically include the following conditions:
The procedure for a transmetacarpal amputation involves several critical steps to ensure the safe and effective removal of the fingers. First, the patient is positioned appropriately, and the surgical site is prepared and sterilized to minimize the risk of infection. Anesthesia is administered to ensure the patient is comfortable and pain-free during the procedure. Next, the surgeon makes an incision over the metacarpal bones, carefully dissecting through the skin and soft tissues to expose the underlying structures. Once the bones of the fingers are fully visualized, the surgeon proceeds to transect the metacarpal bones, ensuring complete removal of the fingers. After the bones are severed, the surgeon meticulously inspects the site for any remaining tissue that may need to be addressed. The wound is then closed, typically using sutures or staples, to promote healing. It is essential to ensure that the closure is secure to prevent complications such as infection or excessive scarring. Finally, the surgical site is dressed appropriately, and post-operative care instructions are provided to the patient.
After a transmetacarpal amputation, patients can expect a recovery period that may vary depending on individual circumstances and the extent of the procedure. Post-operative care typically includes monitoring the surgical site for signs of infection, managing pain with prescribed medications, and keeping the area clean and dry. Patients may be advised to limit movement of the hand to facilitate healing and prevent complications. Rehabilitation may be necessary to help the patient adapt to the loss of fingers and to regain as much function as possible. This may involve physical therapy and, in some cases, fitting for a prosthetic device to assist with hand function. Follow-up appointments are crucial to assess healing and address any concerns that may arise during the recovery process.
| Short Descr | AMPUTATION OF HAND | Medium Descr | TRANSMETACARPAL AMPUTATION | Long Descr | Transmetacarpal amputation; | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | 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 | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 164 - Other OR therapeutic procedures on musculoskeletal system |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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). | 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F4 | Left hand, fifth digit | F6 | Right hand, second digit | F7 | Right hand, third digit | F8 | Right hand, fourth digit | F9 | Right hand, fifth digit | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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