# traumatic amputaion fingers



## bwerner (Nov 24, 2008)

I am having problems finding the code for this.

This mans third and fourth fingertips were amputated by a choker when logging. There was a short fragment of the distal phalanx left, it was debrided by rongeur and VY advancement flaps were done of both the radial side and the ulnar side 

He also debrided some bone fragments on the third finger along with other tissue and he did a AV to Y flap to close the defect.

I'm not seeing a code to be used for the advancement flaps, I would call it an open fracture since "fragments" of the bones were debrided. So, do I code 11012 with HCPS codes per finger? Or do I code complex repair of wound/fingers 13131?

Any suggestion would be great.


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## mbort (Nov 24, 2008)

Look at 26952 it includes the flap and neurectomy


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## bwerner (Nov 24, 2008)

okay, but isn't that code for when the surgeon is the one that is amputating the fingers. The choker amputated them but 26951 says primary or secondary (what exactly does that mean)?


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## mbort (Nov 24, 2008)

Those codes are not strictly for the physician cutting them off.  They are  used most often for traumatic amputations and revisions.


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## bwerner (Nov 24, 2008)

Since I have two fingers here that were amputated. Do I code 26952.F2 and 26952.F3? He did flaps on both open wounds, two flaps on one and one flap on the other.

Thank you for always answering my questions.


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## mbort (Nov 24, 2008)

thats correct, depending on the carrier you may also need a 59 modifier on the 2nd one.  Many carriers do not recognize the "F" modifiers and will deny as duplicate.


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## dmaec (Nov 24, 2008)

Per the Physicians Desk Reference - 26951/26952 is:
The physician amputates a finger or thumb, primary or secondary to injury.  Neurectomies are performed.  The overlying skin is incised and the tissues are dissected to the bone.  The bone is removed.  The vessels and nerves are ligated using microsurgical techniques.  Primary amputations is removal of the digits following and accute inury or infection. Secondary amputation occurs when earlier attempts to preserve the digit have failed.  In 26951, the would is approximated, reduced, and sutured in layers.  In 26952, local advancement flaps are necessary for closure.


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