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Arthrodesis of an interphalangeal (IP) joint is a surgical procedure aimed at fusing the bones of the joint to alleviate pain and restore stability, particularly in cases of arthritis or joint instability. The procedure involves making an incision over the affected IP joint, allowing the surgeon to access the joint capsule. Once the joint is exposed, the surgeon inspects the joint surfaces and excises the articular cartilage from the phalangeal bones. This step is crucial as it prepares the bone surfaces for fusion by smoothing and reshaping them using a bur, ensuring they can be held in the desired position. In some cases, internal fixation devices such as pins or wires may be utilized to maintain the joint in the correct alignment until the fusion process is complete. After the joint surfaces are properly aligned and secured, the soft tissues surrounding the joint are meticulously repaired in layers. Finally, a cast or splint is applied to immobilize the joint during the healing process. It is important to note that CPT® Code 26861 is specifically used for each additional IP joint that undergoes fusion, following the primary procedure coded with CPT® Code 26860. This distinction is essential for accurate medical coding and billing, as it reflects the complexity and extent of the surgical intervention performed.
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Arthrodesis of the interphalangeal joint is indicated for various conditions that compromise the stability and function of the joint. The following are the primary indications for this procedure:
The procedure for arthrodesis of the interphalangeal joint involves several critical steps to ensure successful fusion of the joint. The following outlines the procedural steps:
Post-procedure care following arthrodesis of the interphalangeal joint is critical for successful recovery. Patients are typically advised to keep the affected area immobilized in a cast or splint for a specified duration to promote healing. Regular follow-up appointments are necessary to monitor the healing process and ensure that the joint is fusing properly. Pain management strategies may be implemented to alleviate discomfort during recovery. Patients should also be educated on signs of complications, such as increased swelling, redness, or fever, which may indicate infection or other issues. Rehabilitation exercises may be introduced gradually to restore function and strength to the joint once adequate healing has occurred.
| Short Descr | FUSION OF FINGER JNT ADD-ON | Medium Descr | ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT | Long Descr | Arthrodesis, interphalangeal joint, with or without internal fixation; each additional interphalangeal joint (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 4 | CCS Clinical Classification | 162 - Other OR therapeutic procedures on joints |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 26860 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code Arthrodesis, interphalangeal joint, with or without internal fixation; | 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). | 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. | 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). | 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 | CR | Catastrophe/disaster related | 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 | FP | Service provided as part of family planning program | 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 | T4 | Left foot, fifth digit | T6 | Right foot, second digit | T9 | Right foot, fifth digit | 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 | 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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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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