AHA Coding Clinic® for HCPCS - 2020 Issue 4; Ask the Editor

Dupuytren’s contracture repair

A patient with severe Dupuytren’s disease in the left hand presented for an open fasciectomy of the small finger including release of the distal interphalangeal joint (DIP), proximal interphalangeal (PIP) and metacarpophalangeal (MP) joints, with open fasciectomy of the palm of the index, middle and ring fingers. The small and ring finger procedures were performed through the same skin flap made to the mid-palm. The portion of the small finger pretendinous cord, flexor tendon sheaths, palmar joint capsules and fascial cords were isolated and released. A displaced pretendinous cord was identified and after removal of this cord, the DIP joint contracture was alleviated. The ring finger pretendinous cord was released and the MP joint was brought to full extension.A separate transverse incision was made through the distal palmar crease. The pretendinous cords to the middle and index fingers were isolated and released to the base of the proximal phalanx achieving full extension of the metacarpalphalangeal (MP) joints of the middle and index fingers. The incisions were closed and a double Z-plasty was performed. What are the correct CPT codes for an open fasciectomy of the small finger including release of the DIP, PIP and MP joints with an open fasciectomy of the palm of the index, middle and ring fingers? ...

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