Orthopedic Coding Alert

Find out why "otomy" versus "ectomy" makes all the difference. Watch your surgeon's documentation for clues regarding partial or complete treatment and the number of digits involved, and you'll be on your way to clean Dupuytren contracture release claims every time. What happens: Dupuytren contracture release involves excising contracted fibrotic bands of the palmar fascia. Surgeons can either use a standard open incision with fasciectomy (known as the McCash technique) or percutaneous fasciotomy (known as the Luck technique),says Janet Vanderpuije with OrthoMaryland in Baltimore. Here's how to break down these techniques into coding realities. Fasciotomy Can be Open or Percutaneous If the surgeon completes fasciotomy to treat Dupuytren's contracture (728.6, Contracture of palmar fascia), check the operative notes for whether he used an open or percutaneous approach. Then, choose between 26040 (Fasciotomy, palmar [e.g., Dupuytren's contracture]; percutaneous) or 26045 (... open, partial) and report the correct code for each finger [...]