# Metacarpal volar plate



## wmcodylee (May 25, 2017)

Need CPT code for MP capsulardesis of thumb and volar plate.


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## Orthocoderpgu (May 26, 2017)

*Look at 26850*

I think what your coding is an arthrodesis using a plate. The physician does not want the joint to move and places a plate that is attached to the volar side of the metacarpal bone and the phalanx. This is a MP arthrodesis. Any questions, let me know.


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## AlanPechacek (May 27, 2017)

The above is true if the goal is to fuse/arthrodese the MP Joint of the Thumb.  But a "Capsulodesis" does not do that.  This procedure is usually done for laxity/looseness or instability of the MP joint (usually from a previous injury) that allows the Proximal Phalanx to sublux dorsally or hyperextend at the MP Joint in such a way that there is loss of Pinch Strength with the thumb and another finger.  Capsulodesis of the volar/palmer capsule (which includes the "volar plate") tightens that capsule to limit the extension of the MP joint, restore the volar stability of the joint, and thereby improve pinch strength.  It does limit extension of the joint, but still allows flexion, and thereby maintains some joint motion, which is preferable to a fusion, which eliminates all motion at the joint. If this procedure were to fail, then fusion/arthrodesis would be the next step.  Look at 26516.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com


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