Orthopedic Coding Alert

Learn these terms and you'll be able to link op report terms to procedures

If you find it difficult to select CPT codes based on your surgeon's documentation, you may need a primer to help you equate a procedure with a keyword in the note. Check out the following common hand surgery terms so you can determine whether your hand surgeon performed a synovectomy, fasciectomy, or other procedure.

Fasciotomy (26040-26045): an incision through the fascia. Fasciotomy is used to release contracted palmar fascia as seen in mild Dupuytren's disease.

Decompressive fasciotomy (26037): an incision through a fascia. Surgeons use decompressive fasciotomy to treat certain vascular disorders and injuries when marked swelling is anticipated that could compromise blood flow. For instance, hand surgeons may use fasciotomy to treat a compartment syndrome of the hand, which may occur due to a crush injury. 

Tenotomy (26060): when the physician surgically divides a tendon to relieve a deformity caused by congenital or acquired shortening of the muscle. Hand surgeons commonly perform tenotomy to treat spastic hand disorders in which a tendon contracture occurs.

Arthrotomy (26070-26080): cutting into a joint. Hand surgeons often use arthrotomy to explore a joint for a foreign body or debride a joint for an infection.
 
Fasciectomy (26121-26125): the excision of strips of the fascia, often used for contractures of the hand, most commonly for Dupuytren's contracture.

Synovectomy (26130-26145): when the surgeon excises a portion or all of the synovial membrane of a joint.

Anatomical Terms

Carpal, carpus: pertaining to the wrist, and specifically to the eight small bones of the wrist distal to the radius and ulna.

Carpometacarpal joint: the synovial joint(s) between the carpal and metacarpal bones.

Interphalangeal: pertaining to the two short bones in the finger; pertaining to the joints between the three short bones in the fingers (non-thumb), or the two short bones in the thumb.

Metacarpal: the five bones of the hand between the carpus (wrist) and the phalanges.

Palmar, Volar: referring to the palm of the hand.

Phalanges: the three short bones in the fingers (non-thumb), or the two short bones in the thumb.

Synovial membrane: the connective tissue membrane that lines the cavity of all synovial joints and produces the synovial fluid; it lines all internal surfaces of the cavity except for the articulator cartilage of the bones.