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The procedure described by CPT® Code 26130 refers to a synovectomy of the carpometacarpal (CMC) joint, which is a surgical intervention aimed at removing inflamed synovial tissue from this specific joint. The carpometacarpal joints are located at the base of the thumb and are crucial for hand function, allowing for a range of movements including opposition, which is essential for grasping and pinching. In this procedure, a surgical incision is made over the affected CMC joint, allowing the surgeon to access the joint capsule. Careful dissection of the surrounding soft tissues is performed to protect important nerves and blood vessels that are in proximity to the joint. Once the joint capsule is exposed, it is incised, and the interior of the joint is visually inspected. The primary goal of the synovectomy is to excise the inflamed synovial tissue, which can be a source of pain and dysfunction in the joint. This procedure is particularly indicated in cases of inflammatory conditions such as rheumatoid arthritis or other synovial disorders that lead to chronic inflammation and pain in the CMC joint. By removing the inflamed tissue, the procedure aims to alleviate symptoms and improve the overall function of the hand.
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Synovectomy of the carpometacarpal joint, as described by CPT® Code 26130, is indicated for various conditions that lead to inflammation of the synovial tissue within the joint. The following are specific indications for this procedure:
The procedure for a synovectomy of the carpometacarpal joint involves several key steps, which are detailed as follows:
After the synovectomy is completed, post-procedure care is crucial for optimal recovery. Patients are typically monitored for any immediate complications, and pain management strategies are implemented. The surgical site may be bandaged, and instructions regarding wound care will be provided. Rehabilitation may be recommended to restore mobility and strength in the hand, which may include physical therapy exercises. The expected recovery time can vary based on the individual’s overall health and adherence to post-operative care instructions. Follow-up appointments will be necessary to assess healing and ensure that the joint is functioning properly.
| Short Descr | REMOVE WRIST JOINT LINING | Medium Descr | SYNOVECTOMY CARPOMETACARPAL JOINT | Long Descr | Synovectomy, 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) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
| 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. | 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.) | 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 | 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) | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| Pre-1990 | Added | Code added. |
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