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The CPT® Code 26205 refers to the procedure of excising or curettaging a bone cyst or benign tumor located in the metacarpal bone, accompanied by the use of an autograft, which includes the process of obtaining the graft. A bone cyst is defined as a fluid-filled cavity within the bone, which can vary in type and presentation. One prevalent form is the unicameral or simple bone cyst, recognized as a benign lesion. Another type, the aneurysmal bone cyst, is characterized by vascular tissue that encases a blood-filled cystic lesion. Additionally, there are various benign bone tumors, such as giant cell tumors, chondromyxoid fibromas, and enchondromas, which may also necessitate surgical intervention. The procedure begins with an incision made over the affected metacarpal bone, followed by dissection of the soft tissues to expose the lesion. If a cystic lesion is identified, the bone is incised to create a window, allowing for the aspiration of fluid, which is then sent for laboratory analysis. The lining of the cystic cavity is meticulously removed using a curette. In cases where benign tumors are present, the excision involves removing the tumor along with a margin of healthy bone. Following the excision or curettage, the procedure includes the acquisition of healthy bone, either from the same site or from a donor site, such as the iliac crest, which is then packed into the defect created in the metacarpal bone, facilitating proper healing and structural integrity.
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The procedure described by CPT® Code 26205 is indicated for the treatment of specific conditions affecting the metacarpal bones. These include:
The procedure involves several critical steps to ensure the effective excision or curettage of the lesion:
After the procedure, patients may require specific post-operative care to ensure proper healing. This may include immobilization of the hand to prevent movement at the surgical site, pain management, and monitoring for any signs of infection or complications. Follow-up appointments are essential to assess the healing process and the integration of the autograft into the metacarpal bone. Rehabilitation may also be necessary to restore function and strength to the hand following recovery.
| Short Descr | REMOVE/GRAFT BONE LESION | Medium Descr | EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT | Long Descr | Excision or curettage of bone cyst or benign tumor of metacarpal; with autograft (includes obtaining graft) | 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) | 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 | 1 | CCS Clinical Classification | 142 - Partial excision 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. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | F3 | Left hand, fourth digit | F5 | Right hand, thumb | 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) | 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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