Reviewed on May 20, 2015
Question: Is a sagittal band in the metacarpal (MCP) area an extensor tendon? If the surgeon repairs the sagittal band, which code should we report?
Answer: The saggital band is not an extensor tendon. The sagittal bands stabilize the extensor tendons at the MCP joints. When the bands rupture, the extensor tendon can slip out of place.
If the surgeon repairs the sagittal band due to dislocating extensor tendons, he is most likely centralizing the extensor tendons. You should report 26437 (Realignment of extensor tendon, hand, each tendon) for this procedure.
If your patient suffers from a sagittal band rupture or stretching, your surgeon may document that he reefs the tendon to prevent dislocation or popping. During reefing, the surgeon tightens up structures to stabilize them. Reefing is similar to what surgeons refer to as a "pants-over-vest repair." Code 26437 is appropriate for this procedure as well.