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Diagnostic arthroscopy of the metacarpophalangeal (MP) joint is a minimally invasive surgical procedure that allows for direct visualization and assessment of the joint's internal structures. This procedure is particularly useful for evaluating conditions affecting the MP joint, such as synovial inflammation or damage. During the arthroscopy, small incisions, known as portals, are made on the dorsal (back) side of the hand, specifically at the ulnar and radial aspects of the MP joint, which are located next to the extensor muscle tendon sheath. Care is taken to avoid injury to the dorsal venous plexus, a network of veins in the area. To facilitate the procedure, the portals are infiltrated with a local anesthetic, such as lidocaine, and the joint is distended with saline solution to improve visibility. Finger traction is applied to the digit being examined, which helps to further open the joint space. A needle arthroscope, a specialized instrument equipped with a camera, is then introduced into the MP joint. This allows the physician to inspect the joint cartilage and assess the extent of any synovial inflammation present. If necessary, microforceps are utilized to obtain synovial tissue samples from the most inflamed areas of the synovium. These samples are crucial for laboratory analysis, aiding in the diagnosis of conditions such as rheumatoid arthritis. The overall goal of this diagnostic procedure is to provide early detection and intervention for joint diseases, thereby improving patient outcomes.
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Diagnostic arthroscopy of the metacarpophalangeal (MP) joint is indicated for various conditions that may affect the joint's health and function. The following are the explicitly provided indications for this procedure:
The procedure of diagnostic arthroscopy of the metacarpophalangeal (MP) joint involves several key steps that ensure effective evaluation and sampling of the joint's internal structures. The following procedural steps are outlined:
After the completion of the diagnostic arthroscopy, patients may experience some discomfort and swelling in the affected area. Post-procedure care typically includes recommendations for rest and elevation of the hand to reduce swelling. Ice packs may be applied to alleviate pain and inflammation. Patients are usually advised to avoid strenuous activities involving the hand for a specified period to allow for proper healing. Follow-up appointments may be scheduled to discuss the results of the synovial biopsy and any further treatment options based on the findings.
| Short Descr | MCP JOINT ARTHROSCOPY DX | Medium Descr | ARTHROSCOPY METACARPOPHALANGEAL SYNOVIAL BIOPSY | Long Descr | Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy | 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) | 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 | 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 | 2 | CCS Clinical Classification | 149 - Arthroscopy |
| 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). | 74 | Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53. | 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) |
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| 2011-01-01 | Changed | Short description changed. |
| 2002-01-01 | Added | First appearance in code book in 2002. |
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