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Arthrodesis of the carpometacarpal (CMC) joint of the thumb is a surgical procedure aimed at fusing the joint to alleviate pain and restore stability, particularly in cases of arthritis or joint instability. The CMC joint is located at the base of the thumb, where the metacarpal bone of the thumb meets the trapezium bone of the wrist. This procedure involves the removal of the articular cartilage from the joint surfaces, which is essential for reducing pain and improving function. The surgery may involve the use of an autograft, which is a piece of bone taken from another part of the patient's body, typically the iliac crest, to facilitate the fusion process. The procedure is designed to create a solid union between the bones, thereby eliminating movement at the joint and providing a stable base for thumb function. The use of internal fixation devices, such as pins or wires, may be employed to maintain the proper alignment of the joint during the healing process. Overall, this procedure is critical for patients suffering from debilitating conditions affecting the thumb's CMC joint, allowing for improved quality of life and hand function post-surgery.
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Arthrodesis of the carpometacarpal joint of the thumb is indicated for several specific conditions that compromise the function and stability of the joint. The following are the primary indications for this procedure:
The procedure for arthrodesis of the carpometacarpal joint of the thumb involves several critical steps to ensure successful fusion and recovery. The following outlines the procedural steps:
After the arthrodesis procedure, patients can expect a recovery period that may involve pain management and rehabilitation. The short arm cast will typically remain in place for several weeks to ensure immobilization of the joint and support the fusion process. Patients are advised to follow up with their healthcare provider for monitoring the healing progress and to discuss any necessary physical therapy to regain strength and function in the thumb. It is essential to adhere to post-operative care instructions to optimize recovery and achieve the best possible outcomes.
| Short Descr | THUMB FUSION WITH GRAFT | Medium Descr | ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT | Long Descr | Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft) | 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) | 2 - Payment restriction for assistants at surgery does not apply 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | 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) |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | FA | Left hand, thumb | 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). | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | F5 | Right hand, thumb | F7 | Right hand, third digit | 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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| Pre-1990 | Added | Code added. |
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