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Official Description

Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Closed treatment of interphalangeal joint dislocation, as described by CPT® Code 26770, refers to a non-surgical procedure aimed at correcting a dislocated joint in the fingers, specifically the interphalangeal (IP) joint. An IP joint dislocation typically occurs due to extreme movements such as hyperextension or hyperflexion of the finger, which can result in the bones of the finger becoming misaligned. This procedure is performed without the use of anesthesia, allowing for immediate intervention to restore the joint's normal position. The treatment involves obtaining separate radiographs to assess the extent of the injury before proceeding with the manual reduction of the dislocated joint. The clinician will stabilize the hand and manipulate the dislocated phalanx back into its proper anatomical alignment. Following the reduction, the function of the flexor and extensor tendons, as well as the range of motion of the finger, is evaluated to ensure proper recovery. The finger is then immobilized using a splint to maintain the corrected position during the healing process. It is important to note that if multiple IP joint dislocations are present, each dislocation is reported separately. This code is specifically utilized when the procedure is conducted without anesthesia, distinguishing it from similar procedures that may require anesthetic intervention.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The closed treatment of interphalangeal joint dislocation is indicated for patients presenting with the following conditions:

  • Interphalangeal Joint Dislocation This procedure is performed when there is a dislocation of the interphalangeal joint in the fingers, which may occur due to trauma or injury.
  • Hyperextension or Hyperflexion Injury The procedure is indicated when the dislocation results from excessive bending backward (hyperextension) or forward (hyperflexion) of the finger.
  • Need for Immediate Reduction The treatment is indicated when there is a need for immediate manual reduction of the dislocated joint to restore normal alignment and function.

2. Procedure

The closed treatment of interphalangeal joint dislocation involves several key procedural steps:

  • Step 1: Radiographic Evaluation Prior to any manipulation, separate radiographs are obtained to evaluate the extent of the dislocation and to rule out any associated fractures. This imaging is crucial for determining the appropriate course of treatment.
  • Step 2: Hand Stabilization The clinician secures the hand in a stable position to prevent further injury during the reduction process. This stabilization is essential for effective manipulation of the dislocated joint.
  • Step 3: Manual Reduction The clinician then performs the manual reduction by grasping the dislocated phalanx. For a dorsal dislocation, the joint is slightly hyperextended, while for a volar dislocation, it is slightly hyperflexed. This maneuver allows the dislocated bone to be gently pushed back into its normal anatomical position.
  • Step 4: Function and Range of Motion Assessment After the reduction, the clinician checks the flexor and extensor function of the finger, as well as the range of motion, to ensure that the joint is functioning properly and that there are no complications from the dislocation.
  • Step 5: Immobilization Finally, the finger is immobilized in a splint to maintain the corrected position during the healing process. This immobilization is critical to prevent re-dislocation and to support recovery.

3. Post-Procedure

Post-procedure care involves monitoring the patient for any signs of complications, such as persistent pain or swelling. The immobilization splint should remain in place for a specified duration, as determined by the clinician, to ensure proper healing of the joint. Patients are typically advised on exercises to gradually restore range of motion and strength once the splint is removed. Follow-up appointments may be necessary to assess the healing process and to make any adjustments to the treatment plan as needed.

Short Descr TREAT FINGER DISLOCATION
Medium Descr CLTX IPHAL JT DISLC W/MANJ W/O ANES
Long Descr Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia
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 3
CCS Clinical Classification 148 - Other fracture and dislocation procedure
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.
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
F9 Right hand, fifth digit
LT Left side (used to identify procedures performed on the left side of the body)
F4 Left hand, fifth digit
F2 Left hand, third digit
F3 Left hand, fourth digit
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).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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).
55 Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number.
56 Preoperative management only: when 1 physician or other qualified health care professional performed the preoperative care and evaluation and another performed the surgical procedure, the preoperative component may be identified by adding modifier 56 to the usual procedure number.
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.
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.)
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
ER Items and services furnished by a provider-based, off-campus emergency department
F1 Left hand, second digit
F5 Right hand, thumb
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
FA Left hand, thumb
FS Split (or shared) evaluation and management visit
GC This service has been performed in part by a resident under the direction of a teaching physician
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
PN Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q5 Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
RT Right side (used to identify procedures performed on the right side of the body)
SA Nurse practitioner rendering service in collaboration with a physician
T1 Left foot, second digit
T3 Left foot, fourth digit
T4 Left foot, fifth digit
T5 Right foot, great toe
T6 Right foot, second digit
T7 Right foot, third digit
T8 Right foot, fourth digit
T9 Right foot, fifth digit
U7 Medicaid level of care 7, as defined by each state
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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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Pre-1990 Added Code added.
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