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Orthopedic Coding Alert

READER QUESTIONS:
Determine Whether Bones Are Present for 26587

Question: Our surgeon documented excision of the digits for a patient whose diagnosis is bilateral supernumery digits of the hand. No bone was involved in  the excision. We are leaning toward 26587, but we-re not sure if it's appropriate.  Would you advise?


Wisconsin Subscriber
Answer: Although 26587 (Reconstruction of polydactylous digit, soft tissue and bone) may sound accurate, you can only report this code if the surgeon excises the tissue and bone. Because your surgeon only excised soft tissue, you should instead report 11200 (Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions).

Because -polydactylous digits- and -supernumery digits- are both phrases to describe a patient with extra fingers or toes, either 26587 or 11200 could apply to the claim. Therefore, it's always imperative to confirm whether the surgeon had to remove or reconstruct bone, or whether the digits were comprised of tissue only. Reader Questions were reviewed by Heidi Stout, CPC, CCS-P, coding and reimbursement manager at UMDNJ-RWJ University Orthopaedic Group in New Brunswick, N.J.; and Bill Mallon, MD, orthopedic surgeon and medical director at Triangle Orthopaedic Associates in Durham, N.C.

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