# reduce, pin, externally fixate finger?



## deborahcook4040 (Jan 24, 2014)

How do I bill a closed treatment with manipulation, percutaneous pinning and application of uniplanar small hand external fixator, 5th metacarpal.

I feel like I should be billing CPT 26607 - Closed tx of metacarpal fracture, with manipulation, with external fixation, each bone, *along with *26608 - percutaneous skeletal fixation of metacarpal fracture, each bone. 

These 2 codes are bundled per NCCI edits.

Documentation is as follows:
"Under flouroscopic imaging using a combination of metacarpal/phalangeal joint flexion, as well as superior pressure, as ascribed JAHSS maneuver was used to reduce and correct the angulation of this metaphyseal/diaphyseal fracture of the fifth metacarpal of the right hand. A crossing K wire was then placed from distal to proximal, to help reduce the fracture. Next, in order to provider more secure fixation and allow for earlier mobilization, a small, uniplanar hand external fixator was applied, one pin distal and one pin proximal, connected by a carbon rod."

Can I use a 59 modifier on the 26607?

Thanks
Debby


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## OCD_coder (Jan 24, 2014)

You cannot code both fracture surgery codes 26607 and 26608 when reduction is performed on the same bone/same finger.  What you have is a 26608 and a 2069-51 for the uniplane device.


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## deborahcook4040 (Jan 27, 2014)

Thanks for the advice!


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