Orthopedic Coding Alert

Question: Which codes should we report for a Gamekeeper's thumb repair?

Arkansas Subscriber

Answer: You should report 842.12 (Sprains and strains of wrist and hand; metacarpophalangeal [joint]) as your ICD9 Codes.

If the physician applies an ACE bandage or other strapping material to immobilize the thumb, you should report 29280 (Strapping; hand or finger). If you treat the injury with a thumb spica cast, you should report 29075 (Application, cast; elbow to finger [short arm]).

While many of these injuries can be successfully treated nonoperatively, if the torn ligament is displaced, nonoperative treatment will fail and surgical repair may be necessary. The most common code for these repairs is 26540 (Repair of collateral ligament, metacarpophalangeal or interphalangeal joint).

If the patient has chronic ruptures, the physician might supplement the graft with a tendon graft to replace the ligament. In that case, you should report 26541 (Reconstruction, collateral ligament, metacarpophalangeal joint, single; with tendon or fascial graft [includes obtaining graft]).