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Orthopedic Coding Alert

You be the coder:

Watch for difference between 26356 and 26370

Published on Sat Nov 28, 2009

Question: A patient lacerated both the flexor digitorum superficialis and the flexor digitorum profundus tendons in her finger. Both are in zone 2; how should we code the repair? Minnesota Subscriber Answer: The correct code for the procedure is 26356 (Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath [e.g., no man's land]; primary, without free graft, each tendon), and you can report it for each tendon. Options: Follow your payer's reporting requirements to determine whether to report 26356 as a single line item with two units of service, or report as two line items with modifier 59 (Distinct procedural service) as 26356, 26356-59. Then add the appropriate finger modifiers (FA-F9). Detail: Code 26370 (Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon) describes a similar procedure. Reporting 26370 is incorrect in your situation, however, because the patient's superficialis tendon is not intact.
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