Orthopedic Coding Alert

READER QUESTIONS:

Watch Guidelines for Finger Modifiers

Question: How do I code the procedures when our surgeon corrected two trigger fingers during the same date of service? Nebraska Subscriber Answer: Start with 26055 (Tendon sheath incision [e.g., for trigger finger]), then decide how to apply the correct modifiers. Options include: • Report the appropriate finger modifiers (FA-F4 for left hand and F5-F9 for right hand) • Report LT (Left side) or RT (Right side) as needed. Some payers want RT/LT and modifier 59 (Distinct procedural service) on the surgery codes, but others such as Medicare and Anthem want the specific finger modifiers or just modifier 59. Check your carrier's guidelines before submitting the claim to ensure you report the procedure correctly.
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