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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 to prepare them for fusion. The surfaces of the bones are then smoothed and reshaped using a bur, ensuring they can be held in the desired position for successful fusion. In some cases, internal fixation devices such as pins or wires may be employed to maintain the joint in the correct alignment until the fusion process is complete. After the procedure, the soft tissues are meticulously repaired in layers, and a cast or splint is applied to support the joint during the healing process. This code, CPT® 26863, specifically refers to the arthrodesis of each additional IP joint when performed with an autograft, which is a bone graft taken from the patient's own body, typically harvested from the iliac crest. The use of an autograft enhances the likelihood of successful fusion by providing the necessary biological material to facilitate healing and integration of the joint surfaces.
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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, which are detailed as follows:
Post-procedure care following arthrodesis of the interphalangeal joint is essential for optimal recovery. Patients are typically advised to keep the affected joint immobilized in a cast or splint for a specified period to promote healing and ensure proper fusion of the joint. Pain management strategies may be implemented to alleviate discomfort during the recovery phase. Regular follow-up appointments are necessary to monitor the healing process and assess the success of the fusion. Patients may also be instructed on rehabilitation exercises to gradually restore function and strength to the joint once healing has progressed sufficiently. It is important to adhere to the surgeon's guidelines regarding weight-bearing activities and any restrictions to prevent complications and ensure a successful outcome.
| Short Descr | FUSE/GRAFT ADDED JOINT | Medium Descr | ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT | Long Descr | Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft), each additional 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) | 2 - Payment restriction for assistants at surgery does not apply 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 | 2 | 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.
| 26862 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft) | 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) |
| 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). | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | 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) | SG | Ambulatory surgical center (asc) facility service | T2 | Left foot, third digit | 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. |
| Pre-1990 | Added | Code added. |
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