# Excision Of Accessory Thumb



## IRISHCODER (Feb 11, 2009)

My surgeon did OP surgery to remove an accessory thumb. The only codes I can come up with are 11200 which seems too minor for this procedure, with 64702. Any other ideas? Thanks for your input!  Report is below:
An "X" ws drawn around the accessory thumb which was small and vestigial, but did have a full nailbed and mature nail attached to it.  The ellipse was opened dorsally and dissection begun. There were vestiges of the extensor mechanism travelling to the accessory thumb.  These were divided after being sure no neurovascular bundles were included.  The major neurovascular bundle of the thumb was then approached and dissected distally until the major arterial and digital nerve branches to the accessory thumb were identified.  These were then divided.  Dissection was then performed in the volar direction until the flexor tendon was identified, and this was divided.  The remaining soft tissue attachments and thumb palmar fascia was divided until the accessory thumb was completely free. The resulting elliptical opening was then primarily closed with 4-0 Ethilon.....


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## mbort (Feb 11, 2009)

look at 26587 to see if that works for you 


Mary, CPC, COSC


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## FTessaBartels (Feb 11, 2009)

*No bone involved*

Mary,
NOT my area of expertise, but ...
I don't see that there was any excision of bone... 26587 specifies bone and then the parenthetical remark refers you to 11200 if it's soft tissue only. 

F Tessa Bartels, CPC, CEMC


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## mbort (Feb 11, 2009)

FTessaBartels said:


> Mary,
> NOT my area of expertise, but ...
> I don't see that there was any excision of bone... 26587 specifies bone and then the parenthetical remark refers you to 11200 if it's soft tissue only.
> 
> F Tessa Bartels, CPC, CEMC



You are correct, the suggestion was off the top of my head, I didnt actually look it up in the book to see the parenthetical note, I figured the poster could look at it and see any instruction


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## IRISHCODER (Feb 12, 2009)

*Thanks*

Thanks for confirming what I thought.  Unfortunately it looks like the 11200 is the only code for this procedure. It's more work for the surgeon than it's reimbursement. I appreciate you looking at it with me.


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## FTessaBartels (Feb 12, 2009)

*Add -22 modifier*

How about adding a -22 modifier to 11200?  It's a long shot, but may be worth it. He certainly did more than snip off a skin tag.

F Tessa Bartels, CPC, CEMC


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