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L Posted 5 Year(s) ago

Hi,
I need CPT codes and ICD9 codes for the following:
Dx:
1. Rheumatoid flexot tenosynovitis with left middle finger stenosing tenosynovitis and right index, middle, and ring finger stenosing tenosynovitis.
2. Symptomatic palmar fibromatosis left palm and right palm.

Procedure:
1. Left middle finger A1 release.
2. Excision ulnar superficialis tendon slip.
3. Excision of palmar fibromatosis nodule mid-palm.
4. Right index A1 release with flexor tenosynovectomy.
5. Right middle finger A1 release with ulnar slip superficialis flexor tenectomy.
6. Right ring A1 release with rheumatoid flexor tenosynovectomy and ulnar superficialis slip excision.
7. Palmar fibromatosis nodule excision mid-palm on the right side.
I know the 26055/727.04 for the A1 releases but am unsure what else I need to add.
Thanks!

SuperCoder Posted 5 Year(s) ago

Hi,

Please submit a broader description/ OP report for us to correctly judge the whole scenario.

Thanks

SuperCoder Posted 5 Year(s) ago

There are some variables to consider with this case, primarily whether or not the surgeon performed a radical tenosynovectomy, which I cannot discern from the information provided. Also, it would be important to know whether or not the patient is Medicare primary.

Dx:
1. Rheumatoid flexor tenosynovitis with left middle finger stenosing tenosynovitis (727.03) and right index, middle, and ring finger stenosing tenosynovitis. (727.03 x 3)
2. Symptomatic palmar fibromatosis left palm and right palm. (728.6)

Procedure:
1. Left middle finger A1 release. (26055 – but see 3.)
2. Excision ulnar superficialis tendon slip. (26180)
3. Excision of palmar fibromatosis nodule mid-palm. (26121 – but bundled with 26055 – if part of 1. above can only use either 26055 or 26121)
4. Right index A1 release with flexor tenosynovectomy. (26145)
5. Right middle finger A1 release with ulnar slip superficialis flexor tenectomy.(26180 – 26055 is bundled with 26180 – can only use one of these)
6. Right ring A1 release with rheumatoid flexor tenosynovectomy and ulnar superficialis slip excision. (26145 and 26180 – these are OK together)
7. Palmar fibromatosis nodule excision mid-palm on the right side. (26121 – but see 3. above – is this the same thing? Also bundled with 26055 and 26145)

Posted by L, 5 Year(s). There are 3 posts. The latest reply is from SuperCoder.

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