Orthopedic Coding Alert

Question: Which CPT and ICD-9 codes should I report when the surgeon documents carpal bossing?


Texas Subscriber


Answer: Because a carpometacarpal boss occurs at the base of the second and third metacarpals, it constitutes a -partial- excision. Therefore, you should report 26230 (Partial excision [craterization, saucerization, or diaphysectomy] bone [e.g., osteomyelitis]; metacarpal) when the surgeon documents carpal bossing.

For the diagnosis code, the American Society for Surgery of the Hand recommends 718.04 (Articular cartilage disorder; hand).

If your surgeon thinks that 733.99 (Other and unspecified disorders of bone and cartilage; other) is more appropriate for your patient's case, you should select that code instead.