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The CPT® Code 26215 refers to the surgical procedure involving the excision or curettage of a bone cyst or benign tumor located in the proximal, middle, or distal phalanx of a finger, accompanied by the use of an autograft. A bone cyst is defined as a fluid-filled cavity within the bone, which can vary in type. The unicameral or simple bone cyst is the most common form, characterized as a benign lesion. In contrast, an aneurysmal bone cyst is less common and is composed of vascular tissue surrounding a blood-filled cystic lesion. Additionally, there are various benign bone tumors, including giant cell tumors, chondromyxoid fibromas, and enchondromas, which may also necessitate surgical intervention. The procedure begins with an incision made over the lesion site in the finger's phalanx, 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 for laboratory analysis. The lining of the cystic cavity is then removed through curettage. In cases where benign tumors are present, excision is performed, removing the tumor along with a margin of healthy bone. Following the excision or curettage, an autograft is obtained either from the local area or a separate site, such as the iliac crest, and is packed into the defect created in the phalanx, facilitating healing and structural integrity of the bone.
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The procedure described by CPT® Code 26215 is indicated for the treatment of specific conditions affecting the phalanx of the finger. These include:
The procedure involves several critical steps to ensure the effective removal of the lesion and the successful application of an autograft. The steps are as follows:
Post-procedure care following the excision or curettage of a bone cyst or benign tumor includes monitoring for any signs of infection or complications at the surgical site. Patients may be advised to keep the affected finger immobilized to promote healing and reduce discomfort. Follow-up appointments are typically scheduled to assess the healing process and ensure that the graft is integrating properly with the surrounding bone. Pain management strategies may also be discussed to help alleviate any postoperative discomfort.
| Short Descr | REMOVE/GRAFT FINGER LESION | Medium Descr | EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT | Long Descr | Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger; 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 | 2 | 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. | 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) | 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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