# trigger finger release



## 574coding (Apr 13, 2016)

Hi, If a provider used a 25 gauge needle, trigger finger was injected with lidocaine, the trigger nodule was identified and finger was hyperextended then used a 18G needle and it was inserted just distal to the nodule and cutting was done and free movement of the finger was checked. the needle cut through the horizontal fibers of the A1 pully. Would this be coded as a 20550 or could it be coded as a 26055 tendon sheath incision? - See more at: https://www.supercoder.com/my-ask-an-expert/topic/trigger-finger-release#sthash.vfa6ocqK.dpuf


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## dwaldman (Apr 16, 2016)

This sounds like a percutaneous approach versus what is describe below for the traditional procedure for 26055. What you have provided might be an unlisted code.

The physician makes an incision in a tendon sheath to release tension in the tendon. (For example, this procedure would be performed to relieve trigger finger.) The physician incises the skin overlying the tendon and dissects to the tendon sheath The sheath is incised lengthwise. The incision is sutured in layers


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Below are example of reporting unlisted codes for variants of wrist/hand procedures.

http://www.mdstrategies.com/nl_04_13.html

There is a “percutaneous” procedure (without use of endoscopic visualization) for a carpal tunnel release using a device known as the Manos carpal tunnel release system.  This percutaneous procedure is neither endoscopic nor open and would be reported with CPT code 64999 – Unlisted procedure, nervous system

Brown endoscopic trigger finger release (BETR) or Endotrig is an endoscopic technique now being utilized to release the A-1 pulley for treatment of trigger fingers.  Due to the fact that there isn’t an endoscopic trigger finger release code in the CPT manual the only coding option is 29999 – Unlisted procedure, arthroscopy.


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