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The CPT® Code 26607 refers to the closed treatment of a metacarpal fracture that requires manipulation and the use of external fixation for stabilization. This procedure is specifically indicated for cases where a single metacarpal bone has sustained a displaced fracture, necessitating a more complex intervention than simple immobilization. The term 'closed treatment' indicates that the procedure is performed without making an open incision to access the fracture directly. Instead, the treatment involves manipulating the fracture fragments back into their proper anatomical position through external means. The use of external fixation involves the insertion of pins into the bone, which are then connected to an external bar, allowing for stabilization and alignment of the fractured bone. This method is particularly useful in cases where traditional casting may not provide sufficient support or alignment. The procedure also includes obtaining radiographs to confirm the fracture and the effectiveness of the reduction, as well as performing a neurovascular examination to ensure that the surrounding nerves and blood vessels remain intact throughout the treatment process.
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The closed treatment of a metacarpal fracture with manipulation and external fixation, as described by CPT® Code 26607, is indicated for the following conditions:
The procedure for CPT® Code 26607 involves several critical steps to ensure effective treatment of the metacarpal fracture:
After the procedure, the patient will require careful monitoring and follow-up care. The immobilization device, whether a splint or cast, must remain in place for the duration of the healing process, which may vary depending on the severity of the fracture and the patient's overall health. Regular follow-up appointments are necessary to assess the healing progress through additional radiographs and to make any adjustments to the external fixation as needed. Patients should be advised on signs of complications, such as increased pain, swelling, or changes in sensation, which may indicate issues with the neurovascular status or alignment of the fracture. Rehabilitation exercises may be recommended once the fracture has sufficiently healed to restore function and strength to the hand.
| Short Descr | TREAT METACARPAL FRACTURE | Medium Descr | CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE | Long Descr | Closed treatment of metacarpal fracture, with manipulation, with external fixation, each bone | 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) | 0 - 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 | 148 - Other fracture and dislocation procedure |
| 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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.) | 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 | F7 | Right hand, third digit | F8 | Right hand, fourth 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 | 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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| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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