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Radical resection of a tumor in the soft tissue of the hand or finger, designated by CPT® Code 26118, involves the surgical removal of a tumor that measures 3 cm or greater. The term "soft tissue" encompasses various structures, including muscles, tendons, fat, blood vessels, lymph vessels, nerves, and the tissues surrounding joints. This procedure is primarily indicated for malignant neoplasms, such as sarcomas, but may also be necessary for benign tumors or those of indeterminate nature. The surgical approach typically begins with a skin incision made directly over the tumor or the creation of a skin flap that is elevated to access the underlying tissue. During the procedure, the surgeon meticulously dissects the overlying tissue to expose the tumor, which is then excised en bloc, meaning it is removed in one piece along with a wide margin of surrounding healthy tissue. This wide margin is critical to ensure that all cancerous cells are removed, thereby reducing the risk of recurrence. The radical resection may involve the excision of not only the tumor but also any affected soft tissues, which can include muscles, nerves, and blood vessels. To confirm that the surgical margins are free of tumor cells, a separately reportable frozen section may be performed during the procedure. If any malignancy is detected at the margins, additional tissue will be excised until clear margins are achieved. Post-surgery, drains may be placed as necessary to manage fluid accumulation, and the surgical wound can be closed in layers or may require additional reconstructive procedures, which are reported separately. It is important to note that CPT® Code 26117 is used for the radical resection of soft tissue tumors of the hand or finger that are less than 3 cm in size.
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Radical resection of a tumor in the soft tissue of the hand or finger is indicated for the following conditions:
The procedure for radical resection of a soft tissue tumor in the hand or finger involves several critical steps:
After the radical resection procedure, patients can expect specific post-operative care and considerations. The surgical site will require monitoring for signs of infection, proper drainage management, and adherence to wound care instructions. Patients may experience swelling and discomfort, which can be managed with prescribed pain relief medications. Follow-up appointments are essential to assess healing and to evaluate the results of any margin assessments performed during surgery. Rehabilitation may be necessary to restore function and mobility in the hand or finger, depending on the extent of the resection and any additional reconstructive procedures performed. It is important for patients to follow their healthcare provider's recommendations for recovery to ensure optimal healing and outcomes.
| Short Descr | RAD RESECT HAND TUMOR 3 CM/> | Medium Descr | RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/> | Long Descr | Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; 3 cm or greater | 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) | 2 - Payment restriction for assistants at surgery does not apply 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 | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 160 - Other therapeutic procedures on muscles and tendons |
| 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). | 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. | 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). | 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 | 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 |
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| 2014-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Short description changed. |
| 2010-01-01 | Added | - |
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