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Closed treatment of a carpometacarpal fracture dislocation of the thumb, commonly referred to as a Bennett fracture, involves a non-surgical approach to realign the fractured bones. This type of fracture occurs at the base of the thumb and affects the articular surface of the metacarpal bone, which is crucial for thumb function. The procedure is characterized by the manipulation of the dislocated joint to restore proper alignment without the need for surgical intervention. To assess the extent of the injury, separate radiographs are obtained prior to treatment. The manipulation technique includes applying traction to the thumb while simultaneously extending, pronating, and abducting the metacarpal. Following the reduction of the fracture dislocation, a second set of radiographs is taken to ensure that the bones are properly aligned. Once alignment is confirmed, the thumb is immobilized using a thumb spica cast to facilitate healing and prevent further injury during the recovery process.
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The closed treatment of a carpometacarpal fracture dislocation of the thumb, or Bennett fracture, is indicated for patients presenting with specific symptoms and conditions related to this type of injury. The following are the primary indications for performing this procedure:
The closed treatment of a Bennett fracture involves several critical procedural steps to ensure proper alignment and healing of the thumb. The following outlines the detailed steps involved in the procedure:
Post-procedure care for a closed treatment of a Bennett fracture includes monitoring the patient for any signs of complications, such as increased pain, swelling, or loss of circulation. The thumb spica cast is typically worn for a specified duration, during which the patient is advised to keep the hand elevated to reduce swelling. Follow-up appointments are necessary to assess healing and to obtain additional radiographs if needed. Once the fracture has healed adequately, the cast will be removed, and the patient may require physical therapy to restore full range of motion and strength in the thumb.
| Short Descr | TREAT THUMB FRACTURE | Medium Descr | CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ | Long Descr | Closed treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture), with manipulation | 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) | 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 | 1 | 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). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 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. | 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.) | CR | Catastrophe/disaster related | F2 | Left hand, third digit | F5 | Right hand, thumb | F6 | Right hand, second digit | F8 | Right hand, fourth 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) |
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