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Orthopedic Coding Alert

You Be the Coder:

Arthroplasty

Published on Wed Aug 01, 2001

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.

Question: How should I code for a Swanson revision of the long finger with synovectomy and reconstruction of the proximal phalanx with bone graft?

South Carolina Subscriber

Answer: Because CPT lacks a code for revision of a silicone implant (Swanson) arthroplasty of the finger, report the same CPT code you would use if it were not a revision procedure. In this case, use 26531 (arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint). For the additional work for the bone graft, you can append modifier -22 (unusual procedural services) to the arthroplasty code if your surgeon feels this is warranted. If you do this, send a brief letter and the operative report with the claim. In addition to 26531, you can also report 26320 (removal of implant from finger or hand) for removal of the broken prosthetic implant.



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