# dupuytrens and trigger finger



## scooter1 (May 11, 2015)

Surgeon did a right palmar fasciectomy. then states he did trigger release rt index, rt middle and rt small fingers.
My thought was 26123, and 26125 x2.
However, he does specifically state that he did a release of the A-1 pulley in each of these fingers.
* * * so now I am confused. Should I code 26121 for the palmar and 26055 for the individual trigger fingers ?? ? ?
Example in the report reads . . . : I release the palmar fascia at the proximal aspect, just distal to the transverse carpal ligament and then followed each of the slips of the palmar fascia.  I followed these on the index finger out to the level of the Skoog's fibers and then separated  Skoog's fibers from this, retaining Skoog's fiber and then following the palmar fascia at the central cord
distally. I identified that it was going into the flexor sheath and this was separated from the flexor sheath and removed. I THEN IDENTIFIED that there was moderate synoviits of the flexor tendons and I did do a RELEASE OF THE A-1 PULLEY OF THE RIGHT INDEX FINGER. 
He then goes on to doing the same with the middle and small finger.


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## jjhamer1 (May 11, 2015)

Coding this thru the encoder:
26123-F6 
26125-F7
26125-F9

The physician removes the palmar fascia. The physician incises the overlying skin and subcutaneous tissue. The palmar fascia is exposed and resected. Tendon sheaths are freed. The incision is sutured in layers if possible. Z-plasties are performed or skin grafts are obtained to close the wound if necessary. In 26121, the palmar fascia is removed. In 26123, part of the palmar fascia is removed and flexor tendons at proximal interphalangeal joints are released. Use 26125 to report additional digits.


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