Orthopedic Coding Alert

You be the coder: Watch for difference between 26356 and 26370


- Published on Thu, Dec 31, 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 [...]

Orthopedic Coding Alert
Issue - Dec, 2009
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