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Official Description

Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 26755 refers to the closed treatment of a distal phalangeal fracture in either the finger or thumb, specifically when manipulation is required. This procedure is indicated for cases where the fracture is displaced, meaning that the bone fragments are not aligned properly. The treatment involves manually manipulating the fractured bone fragments back into their correct anatomical position. It is important to note that if multiple fractures are present, each fracture must be reported separately. Prior to the treatment, radiographs, or X-rays, are obtained to confirm the presence of the fracture and to assess the alignment of the bone fragments. Additionally, a neurovascular examination is conducted to ensure that the nerves and blood vessels surrounding the injury are intact, which is crucial for the overall health and function of the finger or thumb post-treatment. Following the manipulation, the finger is immobilized using a splint to maintain the proper alignment during the healing process.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The closed treatment of a distal phalangeal fracture, as described by CPT® Code 26755, is indicated for the following conditions:

  • Displaced Distal Phalangeal Fracture This procedure is specifically performed when there is a displaced fracture of the distal phalanx in the finger or thumb, requiring manipulation to restore proper alignment.
  • Confirmation of Fracture Radiographs are obtained to confirm the presence of the fracture and to evaluate the alignment of the bone fragments prior to treatment.
  • Neurovascular Integrity A neurovascular examination is conducted to ensure that the nerves and blood vessels in the area of the injury are intact, which is essential for the healing process and function of the digit.

2. Procedure

The procedure for the closed treatment of a distal phalangeal fracture with manipulation involves several key steps:

  • Step 1: Radiographic Evaluation Initially, the physician obtains radiographs to confirm the diagnosis of a distal phalangeal fracture. This imaging is crucial for assessing the extent of the fracture and determining whether it is displaced.
  • Step 2: Neurovascular Examination Following the radiographic evaluation, a thorough neurovascular examination is performed. This step is essential to ensure that the nerves and blood vessels surrounding the fracture site are intact and functioning properly, which is vital for the patient's recovery.
  • Step 3: Manipulation of Fracture If the fracture is confirmed to be displaced, the physician will proceed with the manipulation of the fracture fragments. This involves manually reducing the displaced fragments back into their proper anatomical alignment, ensuring that the bones are positioned correctly for optimal healing.
  • Step 4: Immobilization After successful manipulation, the finger or thumb is immobilized using a finger splint. This immobilization is critical to maintain the alignment of the fracture during the healing process and to prevent any further displacement.
  • Step 5: Follow-Up Radiographs Finally, additional radiographs may be obtained to confirm that the fracture fragments remain in the correct anatomical position following manipulation and immobilization.

3. Post-Procedure

Post-procedure care for a closed treatment of a distal phalangeal fracture with manipulation includes monitoring the immobilized finger or thumb for signs of proper healing. Patients are typically advised to keep the splint in place for a specified duration, as determined by the physician, to ensure that the fracture heals correctly. Follow-up appointments may be scheduled to assess the healing process through physical examination and additional radiographs. Patients should also be instructed on signs of complications, such as increased pain, swelling, or changes in sensation, which may indicate issues with healing or neurovascular integrity. Rehabilitation exercises may be recommended once the fracture has sufficiently healed to restore function and mobility to the affected digit.

Short Descr TREAT FINGER FRACTURE EACH
Medium Descr CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA
Long Descr Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each
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 Procedure or Service, Multiple Reduction Applies
ASC Payment Indicator Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6B - Minor 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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
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.
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.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 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.)
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.)
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
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
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
TA Left foot, great toe
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Date
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2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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