Wiki PIP Release w/IP pinning CPT Code

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terribo

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We need help in coding the following procedure. My thoughts were 26123 vs 26525 vs 26440. Any help would be appreciated.

Thank you

Procedure with Wound Class: 1. RIGHT SMALL FINGER PROXIMAL INTERPHALANGEAL (PIP) JOINT CONTRACTURE RELEASE 2. RIGHT SMALL FINGER INTERPHALANGEAL JOINT PINNING X 2 (PIP AND DIP JOINS)

We began by using a combination of Bruner and lateral incisions to developed a radial based flap over the PIP joint. Neurovascular bundles were identified and protected. We identified the volar aspect of the PIP joint and the A3 pulley was released off the ulnar side. There were some crystalline like deposits along the flexor tendons that were sent for crystals and pathology. FDP and FDS tendons were retracted. Beaver blade was used to release the volar plate from its proximal attachment as well as to release the collateral ligaments. We are now able to get the PIP joint fully extended. There was quite a bit of fluid in the joint that was sent for culture. It was clear and serous and did not appear to be purulent. A 0.54 K wire was placed obliquely across the joint to hold it in an extended position. We then placed a second retrograde wire across the DIP joint to hold it fully extended as well. Final images were taken. Pins were bent and cut.
 
Did they do any other fingers at the same time, like a big RA reconstruction or contracture case, or only the Rt small? Was it Duputyren's or what is the dx, why the contracture, trauma? Probably wouldn't do 26123 if not Dupuytren's.
Sounds like 26440.
The wire is almost like an ex-fix but 20690 is too big for it.
There are some codes like the mallet finger one with perc pinning. I wish there was one like that for this example lol
 
Thank you Amy for responding. The patient had a contracture of only the right hand small finger. Per the clinic note, the patient underwent a A1 Pully release for trigger finger of the RT hand small finger and RT CTR in October 23. The patient developed a contracture of the small finger following that procedure. I try to figure things out on my own before I go to the doc...but we are a little at a loss with this one...and in the end, it will probably be a lot simpler than I am making out to be LOL
 
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