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Sesamoidectomy is a surgical procedure that involves the removal of sesamoid bones located in the thumb or finger. Sesamoid bones are small, round bones that are embedded within tendons and serve several important functions, including modifying pressure, reducing friction, and changing the direction of muscle pull. In the human hand, sesamoid bones are not universally present in all individuals, nor are they consistently located in the same areas. Typically, most individuals possess five sesamoid bones in each hand, with two situated in the metacarpophalangeal (MCP) joint of the thumb, one in the interphalangeal (IP) joint of the thumb, one at the MCP joint of the index finger, and one at the MCP joint of the little finger. Less frequently, sesamoid bones may also be found in the MCP joints of the middle and ring fingers, as well as at the distal IP joint of the index finger. The decision to perform a sesamoidectomy is often based on the specific sesamoid bone that requires excision, and the surgical approach is tailored accordingly. The procedure typically involves making an incision over the affected joint, carefully dissecting the overlying tissue while protecting the digital nerves, and inspecting the surrounding joint structures for any signs of injury or disease. The surgeon then locates the sesamoid bone within the tendon through palpation, incises the tendon longitudinally, and excises the sesamoid bone while preserving the tendon’s integrity. Finally, the incisions are closed, and a bulky dressing and splint are applied to support the area during the recovery process.
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The procedure of sesamoidectomy is indicated for various conditions affecting the sesamoid bones in the thumb or finger. These indications may include:
The sesamoidectomy procedure involves several key steps that are performed with precision to ensure optimal outcomes. These steps include:
Post-procedure care following a sesamoidectomy is critical for ensuring proper recovery. Patients can expect to experience some swelling and discomfort in the affected area, which can be managed with prescribed pain medications. It is important to keep the surgical site clean and dry to prevent infection. Patients are typically advised to limit movement of the thumb or finger for a specified period to allow for healing. Follow-up appointments will be necessary to monitor the healing process and to remove sutures if non-absorbable materials were used. Rehabilitation exercises may be recommended to restore strength and range of motion once the initial healing phase has passed. Adhering to post-operative instructions is essential for achieving the best possible outcome from the procedure.
| Short Descr | REMOVE FINGER BONE | Medium Descr | SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE | Long Descr | Sesamoidectomy, thumb or finger (separate procedure) | 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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 | 161 - Other OR therapeutic procedures on bone |
| 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. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | F1 | Left hand, second digit | F5 | Right hand, thumb | F6 | Right hand, second digit | F7 | Right hand, third digit | FA | Left hand, thumb | 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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| 1997-01-01 | Added | First appearance in code book in 1997. |
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