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Arthrodesis of a carpometacarpal (CMC) joint, specifically for digits other than the thumb, is a surgical procedure aimed at stabilizing the joint by fusing the bones together. This procedure is commonly indicated for patients suffering from conditions such as arthritis or instability in the CMC joint, which can lead to pain and functional impairment. The surgery involves making an incision over the CMC joint to access the joint capsule, where the surgeon inspects the joint surfaces. The articular cartilage, which is the smooth tissue covering the ends of bones in the joint, is removed to prepare the surfaces for fusion. The carpal bone is then reshaped to ensure a proper fit with the metacarpal base. In this procedure, an autograft is utilized, which involves harvesting bone from the patient's own body, typically from the iliac crest. This harvested bone is then shaped to fill the defect created by the removal of cartilage and is secured in place to facilitate the fusion of the joint. The procedure concludes with the repair of soft tissues in layers and the application of a short arm cast to support the healing process.
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The arthrodesis of the carpometacarpal joint, specifically for digits other than the thumb, is performed for several specific indications, including:
The procedure for arthrodesis of the carpometacarpal joint involves several critical steps, which are detailed as follows:
Post-procedure care for patients undergoing arthrodesis of the carpometacarpal joint includes monitoring for signs of infection, ensuring proper healing of the surgical site, and managing pain. 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 restore function and strength to the hand once the joint has sufficiently healed.
| Short Descr | FUSION/GRAFT OF HAND JOINT | Medium Descr | ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT | Long Descr | Arthrodesis, carpometacarpal joint, digit, other than thumb, each; 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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 | 2 | 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) |
| 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | F1 | Left hand, second digit | F2 | Left hand, third digit | F4 | Left hand, fifth digit | F5 | Right hand, thumb | F6 | Right hand, second digit | F7 | Right hand, third 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 |
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| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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