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Arthrodesis of the carpometacarpal (CMC) joint of the thumb, designated by CPT® Code 26841, is a surgical procedure aimed at fusing the CMC joint to alleviate pain and restore stability, particularly in cases of arthritis or joint instability. The CMC joint is crucial for thumb function, allowing for a range of motion necessary for grasping and pinching. During the procedure, a surgical incision is made on the lateral side of the thumb, providing access to the joint. The joint capsule is then incised to expose the joint surfaces, which are carefully inspected. The articular cartilage, which can be damaged in arthritic conditions, is excised from both the metacarpal base and the trapezium bone. To ensure proper alignment and fit, the trapezium is smoothed and reshaped using a bur. This meticulous preparation is essential for achieving a successful fusion. In some cases, internal fixation devices, such as pins or wires, may be utilized to maintain the thumb in the correct position during the healing process. After the joint surfaces are prepared and any necessary fixation is applied, the soft tissues are repaired in layers, and a short arm cast is placed to support the thumb as it heals. This procedure is particularly beneficial for patients suffering from debilitating pain and loss of function due to joint degeneration or instability.
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The procedure of arthrodesis of the carpometacarpal joint of the thumb is indicated for the following conditions:
The arthrodesis procedure involves several critical steps to ensure successful fusion of the CMC joint:
Post-procedure care following arthrodesis of the CMC joint includes monitoring for signs of infection, managing pain, and ensuring proper healing of the surgical site. Patients are typically advised to keep the cast dry and intact, and follow-up appointments are scheduled to assess the healing process. Rehabilitation may be necessary to regain strength and function in the thumb once the joint has sufficiently healed. The expected recovery time can vary, but patients should anticipate a period of immobilization followed by gradual reintroduction of movement and activity as directed by their healthcare provider.
| Short Descr | FUSION OF THUMB | Medium Descr | ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ | Long Descr | Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; | 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) | 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 | 1 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
This is a primary code that can be used with these additional add-on codes.
| 20705 | Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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). | 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. | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F2 | Left hand, third digit | F5 | Right hand, thumb | F6 | Right hand, second 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 |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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