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TRIGGER FINGER UNBUNDLING

Camille Posted Wed 11th of March, 2020 19:40:09 PM
QUESTION: 26055 bundles into 26180. However 26055 was performed at the palmar crease and 26180 was performed at the IP crease-separate incisions. Is it acceptable to code 26055 with a -59 due to separate incision cites? THANK YOU VERY MUCH! ************* "The procedure began with an oblique incision in the distal palmar crease overlying the middle finger ray, sharp dissection with a #15 blade, blunt dissection with tenotomy scissors and Ragnell retractor. The A1 pulley identified, cleared of soft tissue. There was a small retinacular cyst on the top. This was excised, and then the A1 pulley was opened with a #15 blade proximally, extended distally with tenotomy scissors under direct visualization. There was complete division of the A1 pulley. The tendon was withdrawn from the wound and hypertrophic tenosynovium sharply debrided. However, this did not completely resolve the triggering. Released a small portion at the beginning of the A2 pulley. This still did not resolve the triggering. There was persistent triggering now on A2, so decision was made to perform a tenotomy of the ulnar slip of the FDS. A separate skin and fascial incision was made about the IP crease. Sharp dissection with a #15 blade, blunt dissection tenotomy scissors and Ragnell retractor. The A3 pulley was opened and the FDP retracted. The ulnar slip of the FDS identified, resected with a #11 blade at its insertion. Tenotomy scissors used to dissect proximally. Then, working between both wounds, dissecting it with the tenotomy scissor, it was then withdrawn. Thus, the tenotomy ulnar slip FDS tendon, separate skin and fascial incision, was completed."
SuperCoder Answered Thu 12th of March, 2020 04:00:10 AM

Hi Camille,

 

Thanks for your question.

 

There is CCI edit between codes 26055 and 26180 and code 26055 is a column 2 code for 26180, but you may use a CCI-associated modifier (e.g. 59) to override the edit under appropriate circumstances. Please make sure the diagnoses should be separate for these procedures. If physician is treating only trigger finger, then report only 26055 for trigger finger.

 

Please feel free to write if you have any question.

 

Thanks

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