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Official Description

Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 26075 refers to an arthrotomy procedure specifically performed on the metacarpophalangeal (MCP) joint, which is the joint located at the base of each finger where it connects to the hand. This procedure involves a surgical incision to explore, drain, or remove loose or foreign bodies from the MCP joint. The MCP joints are critical for hand function, allowing for the flexion and extension of the fingers. During the procedure, the surgeon makes an incision over the affected joint, carefully dissects the surrounding soft tissues while protecting nearby nerves and blood vessels, and exposes the joint capsule. Once the joint capsule is incised, the surgeon inspects the joint for any signs of infection, fluid accumulation, or foreign bodies. If necessary, the joint is flushed with sterile saline or an antibiotic solution to clear any debris. The procedure is comprehensive, addressing any loculated fluid collections and ensuring that any foreign materials are removed. It is important to note that this code is specifically for the MCP joint, and separate codes are used for procedures on other joints, such as the carpometacarpal (CMC) joint or the interphalangeal (IP) joints. Each joint treated during the procedure is reported separately, ensuring accurate coding and billing for the services rendered.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 26075 is indicated for various conditions affecting the metacarpophalangeal (MCP) joint. These indications may include:

  • Joint Infection The presence of infection within the MCP joint, which may manifest as swelling, pain, and limited range of motion.
  • Fluid Accumulation The accumulation of fluid, blood, or pus within the joint space, often requiring drainage to alleviate pressure and restore function.
  • Foreign Body Presence The identification of loose or foreign bodies within the joint that may cause pain, inflammation, or mechanical obstruction during movement.
  • Joint Dysfunction Conditions leading to impaired function of the MCP joint, necessitating exploration and potential intervention to restore normal movement.

2. Procedure

The procedure for CPT® Code 26075 involves several critical steps to ensure effective treatment of the MCP joint. The steps are as follows:

  • Step 1: Incision The surgeon begins by making a precise incision in the skin over the affected metacarpophalangeal joint. This incision is strategically placed to provide optimal access to the joint while minimizing damage to surrounding tissues.
  • Step 2: Dissection Following the incision, the surgeon carefully dissects the soft tissues surrounding the joint. This step is crucial as it involves protecting nearby nerves and blood vessels to prevent complications during the procedure.
  • Step 3: Joint Capsule Exposure Once the soft tissues are adequately dissected, the joint capsule is exposed. The surgeon then incises the joint capsule to gain access to the interior of the joint.
  • Step 4: Joint Inspection With the joint capsule opened, the surgeon visually inspects the joint for any signs of infection, loose bodies, or other abnormalities. This inspection is vital for determining the appropriate course of action.
  • Step 5: Drainage If an infection is present, the surgeon drains any fluid, blood, or purulent material from the joint. This step may involve breaking up loculated fluid collections using blunt dissection techniques.
  • Step 6: Joint Flushing The joint is then flushed with sterile saline or an antibiotic solution using pulsed lavage. This flushing helps to clear debris and reduce the risk of infection.
  • Step 7: Foreign Body Removal If a foreign body is identified within the joint, the surgeon locates and removes it to alleviate pain and restore normal joint function.
  • Step 8: Drain Placement After completing the necessary interventions, drains may be placed within the joint to facilitate continued drainage of any residual fluid.
  • Step 9: Closure Finally, the incision is closed around the drains, ensuring that the surgical site is properly secured for healing.

3. Post-Procedure

Post-procedure care following an arthrotomy of the metacarpophalangeal joint includes monitoring for signs of infection, managing pain, and ensuring proper drainage through any placed drains. Patients may be advised to keep the affected hand elevated to reduce swelling and to follow specific instructions regarding movement and rehabilitation exercises to restore function. Follow-up appointments are essential to assess healing and to remove drains if necessary. The expected recovery time may vary based on the extent of the procedure and the individual patient's health status.

Short Descr EXPLORE/TREAT FINGER JOINT
Medium Descr ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA
Long Descr Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each
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 3
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.

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)
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.
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).
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.
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.)
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
ET Emergency services
F1 Left hand, second digit
F2 Left hand, third digit
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F5 Right hand, thumb
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth 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
T5 Right foot, great toe
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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