© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 26685 refers to the open treatment of a carpometacarpal (CMC) dislocation, specifically for joints other than the thumb. This procedure involves a surgical approach where a dorsal incision is made on the back of the hand to access the dislocated joint. The primary goal of this intervention is to restore the normal alignment of the dislocated joint through open reduction, which is the process of manually repositioning the bones into their proper alignment. During the procedure, the surgeon carefully retracts the extensor tendons to enhance visibility and access to the joint. The joint capsule is then opened to allow for direct manipulation of the dislocated joint surfaces. If necessary, internal fixation is applied to stabilize the joint, with wire fixation being a common method used. After the dislocation is successfully reduced and any required fixation is completed, the joint capsule is repaired, and the surgical wound is subsequently closed. It is important to note that if multiple carpometacarpal joints are treated during the same surgical session, the code 26685 should be reported for each joint that undergoes this open treatment. This procedure is distinct from the treatment of complex carpometacarpal dislocations, which are coded separately under CPT® Code 26686, indicating a more complicated clinical scenario involving recurrent dislocations or delayed treatment.
© Copyright 2025 Coding Ahead. All rights reserved.
The open treatment of carpometacarpal dislocation, as described by CPT® Code 26685, is indicated for specific conditions related to the dislocation of the carpometacarpal joints, excluding the thumb. The following indications are relevant for this procedure:
The procedure for the open treatment of carpometacarpal dislocation involves several critical steps, which are detailed as follows:
Post-procedure care following the open treatment of carpometacarpal dislocation is essential for optimal recovery. Patients are typically monitored for any signs of complications, such as infection or improper healing. Pain management strategies are implemented to ensure patient comfort during the recovery phase. Rehabilitation may be recommended to restore range of motion and strength in the affected hand. Patients are advised to follow specific instructions regarding activity restrictions and follow-up appointments to assess the healing process and the stability of the joint. The overall recovery time may vary depending on the extent of the dislocation and the individual patient's healing response.
| Short Descr | TREAT HAND DISLOCATION | Medium Descr | OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB | Long Descr | Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint | 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) | 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) | P5B - Ambulatory procedures - musculoskeletal | MUE | 3 | 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 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.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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 | 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) | 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 |
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Notes
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| 2008-01-01 | Changed | Code description changed. |
| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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