Wiki Exploration finger flexor tendon

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RebeccaMoney

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I need help with the attached op report CPT . Doctor gave me CPT 26145, Synovectomy, tendon sheath radical flexor tendon, palm or finger. That just doesn't sound correct to me. He mentions towards the end of the procedure that he felt it was not warranted to further extend incision to an exploratory fashion at this time because of a functional FDS and the risk exceeded the benefits. He did release A-5 pulley(26055) but no trigger finger. I don't believe any repair was done so 26356 , repair flexor tendon, which was authorized doesn't sound correct either. Can anyone please help?
Thank you,
 

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RebeccaMoney said:
I need help with the attached op report CPT . Doctor gave me CPT 26145, Synovectomy, tendon sheath radical flexor tendon, palm or finger. That just doesn't sound correct to me. He mentions towards the end of the procedure that he felt it was not warranted to further extend incision to an exploratory fashion at this time because of a functional FDS and the risk exceeded the benefits. He did release A-5 pulley(26055) but no trigger finger. I don't believe any repair was done so 26356 , repair flexor tendon, which was authorized doesn't sound correct either. Can anyone please help?
Thank you,
Click to expand...
This would not be 26145 since there is no documentation that the patient had synovitis. Look at the documented post op diagnosis: Intact FDP tendon. Nothing about synovitis. There was no repair, just exploratory with confirmation the FDP was intact.
 
Last edited:
Orthocoderpgu said:
This would not be 26145 since there is no documentation that the patient had synovitis. Look at the documented post op diagnosis: Intact FDP tendon. Nothing about synovitis. There was no repair, just exploratory with confirmation the FDP was intact.
Click to expand...
I agree with all you said and that is why I was questioning this. What CPT would you use. 26080? Thank you
 
Cannot code 26080 as no joint exploration was performed.
Unfortunately, the way the surgeon documented this case doesn't clearly describe a tenolysis, but it would be reasonable, in this situation, to code for flexor tenolysis, as the surgeon described assessing the tendons and pulling on them to ensure full range of motion. If you start with a loss of motion and, intraoperatively, get the tendons to the point where they are clearly moving normally, is that enough to qualify? Depends on the documentation. This is iffy. I would give the surgeon the option to submit this as tenolysis.

Other than that you could only code 26055 for the pulley release.
N.
 
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