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The CPT® Code 26105 refers to an arthrotomy with biopsy specifically performed on the metacarpophalangeal (MCP) joint, which is one of the key joints in the hand. The MCP joints are located at the base of each finger, connecting the metacarpal bones of the palm to the proximal phalanges of the fingers. This procedure involves making an incision over the MCP joint to access the joint capsule. During the arthrotomy, the surgeon carefully dissects the surrounding soft tissues while protecting vital nerves and blood vessels. Once the joint capsule is exposed, it is incised to allow for direct visual inspection of the joint interior. Tissue samples may be collected from the joint capsule or the synovial membrane for laboratory analysis, which can provide critical information regarding the presence of disease or other pathological conditions. It is important to note that this procedure is reported for each MCP joint that is treated, ensuring that each intervention is accurately documented for coding and billing purposes.
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The procedure associated with CPT® Code 26105 is indicated for various conditions affecting the metacarpophalangeal (MCP) joint. These indications may include:
The procedure for CPT® Code 26105 involves several critical steps to ensure proper access and sampling from the MCP joint. The steps include:
After the arthrotomy with biopsy of the MCP joint, appropriate post-procedure care is essential for optimal recovery. Patients may be advised to rest the affected hand and avoid strenuous activities for a specified period. Pain management may be necessary, and the healthcare provider may prescribe analgesics to alleviate discomfort. Additionally, monitoring for signs of infection, such as increased redness, swelling, or discharge at the incision site, is crucial. Follow-up appointments may be scheduled to assess healing and discuss the results of the laboratory evaluations performed on the collected tissue samples.
| Short Descr | BIOPSY FINGER JOINT LINING | Medium Descr | ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH | Long Descr | Arthrotomy with biopsy; 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) | 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) | P5B - Ambulatory procedures - musculoskeletal | MUE | 2 | CCS Clinical Classification | 159 - Other diagnostic procedures on musculoskeletal system |
| 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | 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) | 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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