Outpatient Facility Coding Alert

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.

 

Remember: 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 and/or with the finger modifiers (FA-F9) as appropriate.

 

Further information: 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.