Orthopedic Coding Alert

Question: Is there a difference between coding metacarpopha­langeal joint arthroplasty and carpometacarpal joint arthroplasty?

Iowa Subscriber

Answer: Though the anatomies where both arthroplasties occur are very similar, they are not the same. For metacarpophalangeal joint arthroplasty, you’ll report 26530 (Arthroplasty, metacarpophalangeal joint; each joint) or 26531 ( … with prosthetic implant, each joint), depending on encounter specifics.

Remember, these codes are per joint, so if the notes indicate that the physician performed metacarpophalangeal joint arthroplasty without implants on three joints, you’d report 26530 x 3.

For carpometacarpal joint arthroplasty, you’ll have to use 25447 (Arthroplasty, interposition, intercarpal or carpometacarpal joints), per CPT^® instructions. Unlike 26530 and 26531, you should report 25447 only once regardless of the number of joints the physician treated. So, if notes indicate that the physician performed carpometacarpal joint arthroplasty on three joints, you’d report 25447.