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The CPT® Code 26070 refers to an arthrotomy procedure specifically targeting the carpometacarpal (CMC) joint, which is one of the five joints located in each hand. These joints serve as the connections between the distal row of carpal bones in the wrist and the proximal ends of the metacarpal bones that form the palm. During this procedure, a surgical incision is made over the affected CMC joint, allowing for direct access to the joint space. The surgeon carefully dissects the surrounding soft tissues while protecting vital structures such as nerves and blood vessels. Once the joint capsule is exposed, it is incised to facilitate a thorough visual inspection of the joint interior. If any signs of infection are present, the surgeon will drain fluid, blood, and any purulent material that may have accumulated. Additionally, any loculated fluid collections are addressed through blunt dissection. To ensure the joint is free of debris, it is flushed with a sterile saline or antibiotic solution using a technique known as pulsed lavage. If a foreign body is identified within the joint, it is meticulously located and removed. After the procedure, drains may be placed to prevent fluid accumulation, and the incision is then closed around these drains. It is important to note that similar procedures on the metacarpophalangeal (MCP) joint or interphalangeal (IP) joint are coded differently, specifically using CPT® Codes 26075 and 26080, respectively. Each of these codes is designated for reporting procedures performed on separate joints treated during the surgical intervention.
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The procedure described by CPT® Code 26070 is indicated for various conditions affecting the carpometacarpal joint. These may include:
The procedure for CPT® Code 26070 involves several critical steps to ensure effective treatment of the carpometacarpal joint. The first step is to make an incision in the skin directly over the affected joint, allowing access to the underlying structures. Following the incision, the surgeon carefully dissects the soft tissues, taking special care to protect surrounding nerves and blood vessels from injury. Once the soft tissues are adequately retracted, the joint capsule is exposed and incised, providing a clear view of the joint interior. The surgeon then inspects the joint visually to assess for any abnormalities, such as signs of infection or the presence of foreign bodies. If an infection is detected, the next step involves draining any fluid, blood, or purulent material that has accumulated within the joint space. To address any loculated fluid collections, the surgeon employs blunt dissection techniques to break them up. After clearing the joint of any debris, the joint is flushed with a sterile saline or antibiotic solution using a pulsed lavage technique, which helps to ensure thorough cleaning. If a foreign body is identified during the inspection, it is carefully located and removed to restore normal joint function. Once the procedure is complete, drains may be placed to facilitate the removal of any residual fluid, and the incision is then closed around these drains to promote healing.
After the completion of the arthrotomy procedure, patients can expect specific post-procedure care to ensure proper recovery. The placement of drains will help manage any fluid accumulation, and these drains will typically be monitored and removed as necessary. Patients may experience some pain and swelling in the affected area, which can be managed with prescribed pain medications. It is essential for patients to follow their surgeon's instructions regarding activity restrictions and rehabilitation exercises to promote healing and restore joint function. Follow-up appointments will be necessary to assess the healing process and to determine if any further interventions are required. Overall, the expected recovery time will vary based on the individual patient's condition and the extent of the procedure performed.
| Short Descr | EXPLORE/TREAT HAND JOINT | Medium Descr | ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT | Long Descr | Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint | 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) | 1 - Statutory 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) | P5B - Ambulatory procedures - musculoskeletal | MUE | 2 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
This is a primary code that can be used with these additional add-on codes.
| 20700 | Add-on Code MPFS Status: Active Code APC N ASC N1 Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure) | 20704 | Add-on Code MPFS Status: Active Code APC N Manual preparation and insertion of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) | 20705 | Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) |
| 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). | 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. | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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.) | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F1 | Left hand, second digit | F2 | Left hand, third digit | F3 | Left hand, fourth digit | F5 | Right hand, thumb | F6 | Right hand, second digit | F7 | Right hand, third digit | FA | Left hand, thumb | 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) | SG | Ambulatory surgical center (asc) facility service | 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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| Pre-1990 | Added | Code added. |
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