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The CPT® Code 26776 refers to the procedure known as "Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation." This procedure is specifically designed to address dislocations of the interphalangeal joints, which are the joints located between the phalanges (bones) of the fingers and toes. In this context, a dislocation occurs when the bones of the joint are displaced from their normal anatomical position, leading to pain, swelling, and impaired function. The procedure involves a minimally invasive approach, where a small incision is made over the distal phalanx, allowing for direct access to the joint. A drill is then utilized to create a corticotomy, which is a surgical procedure that involves cutting through the outer layer of the bone to facilitate the reduction of the dislocated bones. Once the dislocated phalangeal bones are realigned to their proper anatomical position, one or more pre-bent Kirschner wires are inserted into the medullary canal of the phalanx, crossing the interphalangeal joint to stabilize the reduction. The success of the procedure is confirmed through radiographic imaging, ensuring that the bones are properly aligned. It is important to report CPT® Code 26776 for each interphalangeal joint dislocation that is treated using this percutaneous fixation technique, as it accurately reflects the surgical intervention performed.
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The procedure described by CPT® Code 26776 is indicated for the treatment of dislocations of the interphalangeal joints. These dislocations may occur due to various traumatic events, such as falls, sports injuries, or accidents, leading to symptoms that necessitate surgical intervention. The primary indications for performing this procedure include:
The procedure for CPT® Code 26776 involves several critical steps to ensure the successful reduction and stabilization of the dislocated interphalangeal joint. The steps are as follows:
After the completion of the procedure, appropriate post-operative care is essential for optimal recovery. Patients may be monitored for any signs of complications, such as infection or improper healing. Pain management strategies will be implemented to ensure patient comfort. The affected finger or toe may be immobilized to allow for proper healing, and follow-up appointments will be scheduled to assess the healing process and the stability of the fixation. Rehabilitation exercises may be recommended to restore function and strength to the joint once healing has progressed adequately.
| Short Descr | PIN FINGER DISLOCATION | Medium Descr | PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ | Long Descr | Percutaneous skeletal fixation of interphalangeal joint dislocation, single, 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) | 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 | 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) | P6B - Minor procedures - musculoskeletal | MUE | 4 | CCS Clinical Classification | 148 - Other fracture and dislocation procedure |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | 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. | 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.) | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | 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 | 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 | 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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