We told the surgeon that only one CPT code may be reported because a single cast was . Supine with hand table, tourniquet high on the arm. Recovery can take longer if you develop complications after surgery. If the hardware gets infected, it might need to be removed. (May compress in syringe for firmer graft), Splint in "safe" position (wrist extended 15-20 degrees, MCP joints flexed 70 degrees, PIP joint in 0-10 degrees flexion), Post-op: Splint in "safe" position (wrist extended 15-20 degrees, MCP joints flexed 70 degrees, PIP joint in 0-10 degrees flexion), 7-10 Days: remove splint. This surgery is performed on an outpatient basis meaning you will be able to go home that day. Generally, ORIF is an urgent surgery. These bones are analogous to the metacarpal bones found in the hand. We told the surgeon that only one CPT code may be reported because a single cast was applied. Copyright 2023 Lineage Medical, Inc. All rights reserved. Bennett fragment < 20% of the articular surface: CRPP. When multiple injuries occur, it may be necessary for the physician to perform multiple procedures to restore lost functioning. After a joint reconstruction, we have been billing for a joint injection for pain management or aspiration of an effusion in the operated joint with a modifier 58. Current Procedural Terminology (CPT) includes references to specific locations in the forearm, wrist, hand, and fingers for reporting flexor and extensor tendon repair codes. Coding for the second debridement is 11011-58. I reviewed CPT 20900 but thought not to bill because it states 'autogenous' bone graft/harvest. Place in removable splint with fingers buddy-taped. Open treatment refers to the . The main goal of our organization is to assist physicians looking for billers and coders. Remember, you can direct specific coding questions to the AAOS for review by the Coding, Coverage, and Reimbursement Committee and AAOS staff. ORIF of closed metacarpal fractures allowed for earlier mobilization when compared with CRPP without compromising fracture stability, clinical or functional short-term outcomes. However, a subset of metacarpal shaft or neck fractures cannot be reduced by closed means or are unstable after reduction. The orthopaedic surgeon did not assist on any part of the procedure other than the associated bone graft work. Two days later, the patient was returned to OR and the dressing was removed. The information on this website is intended for orthopaedic surgeons. We give you the tips you need to heal well, A humerus fracture is a break in the large bone of your upper arm. . ORIF is a two-part procedure. Metacarpal Fracture Procedure CPT Codes Closed treatment of metacarpal fracture, single; without manipulation, each bone (26600) Closed treatment of metacarpal fracture, single; with manipulation, each bone (26605) Closed treatment of metacarpal fracture, single; with manipulation, with internal or external fixation, each bone (26607) Be sure to follow CPT coding rules and the AAOS Complete Global Service Data for Orthopaedic Surgery when reporting all services. 35-1 and 35-2 ). 26650. Pre-bend plate with gradual 5 degree contour over the entire length of the plate. It is not intended for the general public. A. no bath tubs, swimming pools, washing dishes, etc.). An anesthesiologist will give you general anesthesia. For a smooth recovery, heres what you can do at home: Its important to attend all your checkups after surgery. Open reduction and internal fixation (ORIF) surgery with plates and screws was performed and range of motion with hand therapy was begun early. "All Rights Reserved." Open Reduction Of Fracture With Internal Fixation, Carpals And Metacarpals. Metatarsal Fracture ORIF Alternatives. Prospectively collected data of 25 consecutive patients were evaluated retrospectively, assessing stability of fixation, operation time and the occurrence of fracture dislocation during and . managing3. cpt code for orif greater tuberosity fracture. You may also need to repeat the surgery if the fracture doesnt heal properly. He was treated with a Rolando Fracture Hook Plate from the Acumed Hand Fracture System. There are several, Sometimes casts are necessary. This column addresses recently asked questions on coding orthopaedic procedures. 26645. These are considered to be follow-up care during the global period, unless the patient is returned to an approved operative suite. Metacarpal Fracture with ORIF 1160 Kepler Drive 1 | Page Green Bay, WI 54311 920-288-5555 . Multiple metacarpal fractures Who is right? Both CRPP and ORIF are viable techniques with good clinical outcomes and low complication rates. There are several types of humerus fractures, depending on the location of the. Typically follow up appointments are scheduled in two-week intervals following surgery, so we can monitor your recovery. Meniscal repair and meniscectomy You might be put on a breathing tube to help you breathe properly. Dr. Hand reports two CPT codes to non-Medicare patients for the non-manipulative treatment of the metacarpal and distal radius fractures. Get the facts on fractures and learn about diagnosis and treatment. It's common in athletes and people who try to do too much activity too quickly. After pin removal, you will be referred for Occupational Therapy of the affected hand and wrist. If you have a leg fracture, you might have to stay longer. If you have an arm fracture, you may go home later that day. After the bone heals, this hardware isnt removed. Despite the increasing success rate of ORIF, recovery depends on your: ORIF is performed by an orthopedic surgeon. I billed CPT 28470 x3, which is defined as 'closed treatment of metatarsal fracture; without ma-nipulation, each'. Correction of a misalignment of the broken bones involves making an incision and aligning the broken bones back into place. Orthobullets Team % TECHNIQUE VIDEO 0 % TECHNIQUE STEPS 0. Metacarpal Injuries: Open Treatment CPT Codes Open treatment of metacarpal fracture, single, with or without internal or external fixation, each bone (26615) Open treatment of articular fracture, involving metacarpophalangeal or proximal interphalangeal joint, with or without internal or external fixation, each (26746) xk~]A 'vZI|u On the day of the accident, the patient was brought to the OR, and the open fracture was debrided of all necrotic tissue and debris. Motion: Metacarpal neck fracture right icd-10. 2021 Jul;48 (4):384-388. doi: 10.5999/aps.2021.00122. Q: The pediatric spine surgeons perform a procedure they call VEPTR. From the operative note, it appears that they are placing instrumentation only without any associated fusion. CPT code 28615 would be reported for the fixation of the dislocation. That's what I get for going by Cpt book only. INTRODUCTION Fourth and fifth metacarpal shaft fractures are one of the most common hand injuries encountered in clinical practice. Metacarpal shaft fractures Diagnosis Radiographic diagnosis confirmed by history, physical exam, and radiographs Treatment Nonoperative immobilization indications may be used for extra-articular non-displaced fracture Operative ORIF indications most fractures are intra-articular and require open reduction technique The surgeon will attach metal rods, screws, plates, or pins to the bone to hold it together. If union is complete return to full activities. Closed reduction and percutaneous pinning is commonly used for low-energy metacarpal shaft and neck fractures (Figs. [26] Preserve the vascular supply that enters through the dorsoradial ridge. This scenario does not meet the intent of modifier 58 because neither the joint injection nor the aspiration meets the staged or planned procedure definition. Intraarticular fracture of the metacarpophalangeal (MP) joint presents complex problems related to the sophisticated functional aspects of the hand. The information on this website may not be complete or accurate. During this procedure, the surgeon will stabilize the bones with a variety of hardware in . In your scenario, the NCCI edits state, If multiple dislocations and/or fractures are treated without manipulation and stabilized with a single cast, strapping, or splint, only one CPT code for closed dislocation or fracture treatment (without manipulation) may be reported.. Most metacarpal fractures occur in the active and working population, particularly adolescents and young adults. Once your bones begin to heal, your doctor may have you do physical or occupational therapy. There are many types of skull fractures, but only one major cause. These moves will help you regain strength and movement in the area. 4 0 obj The subcutaneous tissue and skin were excised with a No. (2012). 0 . 1 0 obj You will wear your splint at all times for 4-6 weeks. Q: Can we report CPT codes 26615 and 26605 when a patient has multiple metacarpal fractures and the physician manages the fractures in the same session? After 4-6 weeks, pin is removed easily in our office, and does not require another surgery. ICD-9-CM Fracture Coding Care of complications of fractures, such as a malunion or a nonunion, are coded with appropriate codes for those conditions 733.81 and 733.82, respectively. You may be correct if the payor is Medicare and hence the confusion sets in. All bony prominences well padded. Metacarpal Neck Fracture ORIF/ CRPP 26615. (2015). As per the CPT manual, debridement may be reported separately when one of the following occurs: prolonged cleansing, appreciable amounts of devitalized tissue are removed, and/or debridement is carried out without immediate primary closure. CPT states that surgical procedures include the operation per se, local infiltration, metacarpal/digital block, or topical anesthesia when used, and normal, uncomplicated follow-up care. But if the chondroplasty is performed in a different compartment, Medicare instructs the physician to report G0289. Depending on your fracture and risk for complications, your procedure might be done immediately or scheduled in advance. The Center for Medicare and Medicaid Services (CMS) via the National Correct Coding Initiatives (NCCI) published Medicare payment rules for Part B Medicare. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Fracture coding submenus; Hand Surgery CPT Codes, sorted by number; Extraarticular Metacarpal Fx CPT Codes; Metacarpal Injuries: Open Treatment CPT Codes . ORIF of First Metacarpal Base Fracture - Rolando Fracture Hook Plate Case Study August 14, 2017 Document A 55-year-old, right-hand-dominant male fractured the base of his right first metacarpal during a fall at work. Debridement of an open fracture and/or dislocation is not accurately described with the 1104211047 CPT codes. The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care". To ensure accurate reporting, report the surgical CPT codes according to the AMA CPT rules; apply payor rules appropriately based (e.g., Medicare NCCI payment rules are applied for Medicare Part B beneficiaries; private payor rules will vary based on contractual agreements). Metatarsal Fracture ORIF Indications. Metacarpal Neck Fracture ORIF Follow-up care. The second part is internal fixation. Metacarpal base fractures can present as both extra and intra-articular injuries. As with any surgery, there are potential risks and side effects associated with ORIF. Learn what to expect for treatment and recovery. Each fracture that is evaluated and treated and meets a global fracture code is reportable assuming unbundling is not occurring. 2008-2023 eORIF LLC. Above mentioned codes only report debridement of open fractures and dislocations. 2008-2023 eORIF LLC. Open fractures are those in which the bone and/or joint is exposed to the external environment or a fracture or dislocation caused by a blunt or penetrating force sufficient to disrupt or penetrate skin layers, subcutaneous tissue, muscle fascia/muscle, and bones or joints. Rasouli MR, et al. 2 0 obj ;O^#v;3$%C"Nya8?_0?_|96c;q;Xoo_}W|{e!Uq,#JL[=C24KWxqwo^Y^n/fUjScW+`,+I \JHCuYu:HYx?`v2IV.FJwJ(%ASt& `&g Diagnosis can be made by orthogonal radiographs of the thumb. -"e splint may be cut down to hand-based only at 4 weeks. Encourage gentle ROM. Study now. Encourage gentle ROM. 28485 Open treatment of metatarsal fracture, includes internal fixation. ORIF is performed by an orthopedic surgeon. The metacarpal shaft fractures are often produced by longitudinal compression, torsion, or direct impact. The fractures were angulated and the fingers were not aligned well. The type of hardware used depends on the location and type of fracture. Humerus Fracture: How Long Will It Take to Heal? 3 0 obj *This response is based on the best information available as of 06/08/17. See Site Terms / Full Disclaimer. The surgery can take several hours, depending on the fracture. Youll need physical or occupational therapy, pain medication, and lots of rest. As mentioned earlier, open fractures have considerable contamination with foreign bodies and devitalized tissue. Open reduction means a surgeon makes an incision to re-align the bone. An orthopedic surgeon cuts the skin, re-positions the bone, and holds it together with metal hardware like plates or screws. Q: We are a new practice and our coders are new to orthopaedic surgery coding. A: VEPTR stands for vertical expandable prosthetic titanium rib. It is used to treat thoracic insufficiency syndrome, a congenital condition in which severe deformities of the chest, spine, and ribs prevent normal breathing and lung growth and development. Absolute stability is achieved using compression plate principles. 26615. It may not display this or other websites correctly. What is an ORIF? Conclusions: Although for both techniques good functional outcomes were reported, the significance of the functional impairment after ORIF requiring reoperation suggests ORIF to be a less favorable technique for single, closed metacarpal shaft fractures. hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/ankle_fracture_open_reduction_and_internal_fixation_135,304, orthoinfo.aaos.org/en/treatment/internal-fixation-for-fractures/, intermountainhealthcare.org/ext/Dcmnt?ncid=521402750, hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/femur_fracture_open_reduction_and_internal_fixation_135,334, ncbi.nlm.nih.gov/pmc/articles/PMC4507072/, covingtonortho.com/surgeries/surgical-trauma-orifetc/, Everything You Need to Know About a Tibia Fracture. Surgery was recommended for the patient. Excellent results can A: AMA CPT rules describe codes 26615 and 26605 as follows: Note that in each description the instructions are to report the procedure code for each bone. Your scenario, as described, would be reported with 26615 and 26605-59. T TonyaMichelle Guru Messages 200 Best answers 0 Nov 18, 2011 #2 Bone Graft I would use Codes: When an open fracture or dislocation debridement code is reported, the diagnosis must correspond to an open fracture. Specialist surgical procedure used to fix fractures. People seeking specific medical advice or assistance should contact a board certified physician. Since orthopedic surgeon Sir Robert Jones first described these fractures in 1902, there has been an abundance of literature focused on the proximal aspect of the fifth metacarpal due to its tendency towards poor bone healing. The splint will gradually be discontinued in the weeks to follow as you progress with occupational therapy. Internal fixation allows for anatomical reduction, early active motion and shorter rehabilitation. But there are things about getting around that youre just not ready for. Open reduction and internal fixation of metacarpal fractures using a thermoplastic splint as a surgical instrument Open reduction and internal fixation of metacarpal fractures using a thermoplastic splint as a surgical instrument Arch Plast Surg. Michael J. Garcia, MD, (Tampa, FL) presents metacarpal fracture fixation using an intramedullary, partially threaded Compression PT Screw. While showering, you may use soap and water, but be sure to pat the incision dry. Resource Type: Phase 1- Early Protective Phase (0 weeks - 2 or 3 weeks) Goals for phase 1 Protect healing fracture and surgical fixation Reduce pain & edema ; Other considerations If multiple digits are involved, a forearm-based safe position splint . Contact our Account Receivables Specialist today! See Site Terms / Full Disclaimer. The goal of the metatarsal fracture fixation (open reduction and internal fixation) procedure is to correct a fracture of one or more of the long bones of the foot, called the metatarsus. The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care". If two metacarpals use single incision between them. Screw Fixation. If you have a scheduled surgery, you may have to fast and stop taking certain medications first. Theyll also check the nerves near the broken bone. "American Academy of Orthopaedic Surgeons" and its associated seal and "American Association of Orthopaedic Surgeons" and its logo are all registered U.S. trademarks and may not be used without written permission. The open fracture of the femur is 27269, and the debridement would be 11010, along with a -59 modifier to bypass any edit. If plates or screws are used to fix the fracture they will remain in place indefinitely, unless causing pain for patient. While the information on this site is about health care issues and sports medicine, it is not medical advice. KarenZupko & Associates, Inc. 2023 | All Rights Reserved, Total Thyroidectomy and Reimplantation of Parathyroids, Tympanoplasty with Middle Ear Exploration. Metacarpal Fractures Pathway Updated: 10/4/2016. Metacarpal Fractures are the most common hand injury and are divided into fractures of the head, neck, or shaft. Wiki User. Open Reduction and Internal Fixation (ORIF). My MAC approved one. A splint was applied after the ORIF procedure to stabilize both fractures. In the United States, upper-extremity injuries result in over 16 million days off of work and a further 90 million days of restricted activity. Open Reduction and Internal Fixation (ORIF) involves fixing severely broken bones and placing them back together using pins, plates, or screws. Metacarpal fractures are among the most common hand injuries, often caused by a direct blow to the hand or by axial load. Staying off your ankle will prevent complications and help the bone and incision heal. You are using an out of date browser. These fractures tend to be unstable, and bone healing is often prolonged. Fractures Question: "The emergency de-partment referred me a patient with three non-displaced metatarsal frac-tures right foot. Surgery: Correction of a misalignment of the broken bones involves making an incision and aligning the broken bones back into place. M20.012 Mallet finger left finger (s) Metacarpal Neck Fracture S62.339A. February 27, 2023 alexandra bonefas scott No Comments . The information on this website is intended for orthopaedic surgeons. Open Reduction and Internal Fixation (ORIF) involves fixing severely broken bones and placing them back together using pins, plates, or screws. Modifier 59 would be appended to the lesser-valued procedure (26605) to indicate that the nonmanipulative treatment of the fracture is for a separately identifiable bone. If this is your first visit, be sure to check out the. Fracture management starts with an appreciation of the normal architecture of the hand; fluency with the names and locations of the bones; and comprehension of how the normal extrinsic and intrinsic muscle forces, after fracture, challenge a less than stable skeleton. Information in this article has been reviewed by members of the AAOS Coding, Coverage, and Reimbursement Committee. Your doctor might be able to treat the break with closed reduction or a cast or splint. Depending on your. Is this correct? The podiatrist requested the orthopaedic surgeon to harvest the graft. This is rare. They are described by the appearance of their respective fracture patterns and can be divided by transverse, oblique, spiral, and comminuted. Internal fixation means the bones are held together with hardware like metal pins, plates, rods, or screws. An external fixator device was used, and a dressing was applied to the open area. Metatarsal Fracture ORIF Pre-op Planning. Image Source: Case courtesy of Leonardo Lustosa, Radiopaedia.org, rID: 98585 Case courtesy of Mohammad Osama Hussein Yonso, Radiopaedia.org, rID: 98747 The hand surgeon submitted two CPT codes, one for the metacarpal fracture and one for the distal radius fracture. 1st metacarpal base intra-articular fracture (below). You can learn more about how we ensure our content is accurate and current by reading our. Open reduction internal fixation (orif) is a surgery to fix severely broken bones. This procedure requires general anesthesia (you'll be asleep . Medicare payment rules are specific to payments and occasionally require the use of a different code when reporting services. Healthline Media does not provide medical advice, diagnosis, or treatment. The audit stated that Medicare has a zero modifier with the 29877 code, indicating that the meniscal repair also includes the chondroplasty. Your question raises several concerns. The surgery is used to fix fractures in the arms and legs, including bones in the shoulder, elbow, wrist, hip, knee, and ankle. They were under the impression that only the meniscectomy included the chondroplasty. Coding additional procedures can boost your bottom line by $500. Prep and drape in standard sterile fashion. You may be a candidate for ORIF if you have a serious fracture that cant be treated with a cast or splint, or if you already had a closed reduction but the bone didnt heal correctly. Anatomy for Hand Fracture Management. registered for member area and forum access. These tests will allow the doctor to examine your broken bone. endobj You will be sent for a custom splint that is removable for showering ONLY. Open reduction internal fixation (ORIF) involves a surgical approach to "reducing" or resetting the bones. <> We are catering to more than 40 specialties, Medical Billers and Coders (MBC) is proficient in handling services that range from revenue cycle management to ICD-10 testing solutions. How do we report this procedure? In a recent multiple trauma case, the patient had a displaced metacarpal fracture requiring an open reduction internal fixation (ORIF), a nondisplaced metacarpal fracture, and other fractures. 1995-2023 by the American Academy of Orthopaedic Surgeons. 6 Weeks: Check xrays. Fractures occurring in the outer bones of the foot are called 5th metatarsal fractures. Treatment is based on which metacarpal is involved, location of the fracture, and the rotation/angulation of the injury. We avoid using tertiary references. The official definition of CPT code 26600 (Closed treatment of metacarpal fracture, single; without manipulation, each bone) instructs the physician to report CPT code 26600 for each bone that is fracture and treated without manipulation. Bennett Fractrue ORIF Indications. Metatarsal Fracture ORIF Contraindications. VEPTR insertion Comminuted fracture patterns not amenable to screw fixation Open reduction internal fixation (ORIF) Indicated when greater than 1 mm displacement in intra-articular fractures (Bennett or Rolando fracture patterns) and comminuted fracture fragments involving the metacarpal base when the fragments are large enough and amenable to screw fixation The podiatrist reports the appropriate arthrodesis procedure code. Metacarpal neck fracture left icd-10. Metacarpal DCP Plating for Transverse Fracture, Metacarpal Fracture Closed Reduction and Pinning, Metacarpal Neutralization Plate with Lag Screw Fixation for Short Oblique Fracture, Surgical Excision of Dorsal Ganglion Cyst, concomitant and associated orthopaedic injuries, differential diagnosis and physical exam tests, documents failure of nonoperative management, describes accepted indications and contraindications for surgical intervention, diagnose and management of early complications, describe complications of surgery including, MCP or interphalangeal capsular contractures, describe the steps of the procedure verbally prior to the start of the case, patient placed in the supine position with hand on hand table, place tourniquet high on the affected extremity, make a longitudinal or curvilinear incision over the metacarpal head, this will facilitate the exposure of the fracture, use a dental pick or small pointed reduction forceps to reduce the fracture, insert guidewires from a cannulated headless screw set, insert headless screws over the guidewires, check the screw placement and fracture reduction radiographically, close the periosteum and the interosseous muscle fascia over the plate, this provides a smooth gliding surface for the extensor mechanism, close the extensor mechanism with 4-0 nonabsorbable suture, schedule follow up appointment in 2 weeks. The bone utilized for the case in question is an allograft. Codes 1101011012 can be used for debridements performed at the same time as the fracture reduction and fixation or for initial debridement and reduction at a later date. 2012 ICD-9-CM Procedure 79. Q: The podiatrist in our office recently performed an arthrodesis procedure that required bone graft to be harvested from the iliac crest. (n.d.). While the information on this site is about health care issues and sports medicine, it is not medical advice. How does the orthopaedic surgeon report the bone graft? endobj This patient sustained displaced fractures of the fourth and fifth metacarpal shafts. G56.01 - Carpal tunnel syndrome, right upper limb, G56.02 - Carpal tunnel syndrome, left upper limb, M72.0 - Palmar fascial fibromatosis [Dupuytren], M65.041 - Abscess of tendon sheath, right hand, M65.042 - Abscess of tendon sheath, left hand, S63.8X1A Sprain other right wrist and hand, Z96.631 Presence of right artificial wrist joint, S63.38X2A Sprain other left wrist and hand, Z96.632 Presence of left artificial wrist joint, S63.8X1A Sprain other right hand and wrist, S63.8X2A Sprain other left wrist and hand, S62.211A Bennett fracture right hand, initial closed, S62.212A Bennett fracture left hand, initial closed, Carpometacarpal Fracture- Dislocation S63.056A, S62.109A, S62.309A, Carpometacarpal fracture dislocation CRPP 26676, S63.054A Dislocation of other carpometacarpal joint of right hand, initial encounter, S63.055A Dislocation of other carpometacarpal joint of left hand, initial encounter, M19.041 Primary osteoarthritis, right hand, M19.042 Primary osteoarthritis, left hand, Distal Phalanx Fracture Open treatment 26765, S52.501A Unspecified fracture of the lower end of right radius, initial encounter closed fracture, S52.531A Colles' fracture of right radius, initial encouter for closed fracture, S52.502A Unspecified fracture of the lower end of left radius, initial encounter closed fracture, S52.532A Colles' fracture of left radius, initial encouter for closed fracture, S63.011A Subluxation of distal radioulnar joint of right wrist, initial encounter, S63.014A Dislocation of distal radioulnar joint of right wrist, initial encounter, S63.012A Subluxation of distal radioulnar joint of left wrist, initial encounter, S63.015A Dislocation of distal radioulnar joint of left wrist, initial encounter, Dupuytren's Contracture Excision CPT 26123, Extensor Tendon Injuries M66.249 S61.409A S66.929A, S66.22_A Laceration of extensor at wrist and hand level, right, S56.42_A Laceration of extensor at forearm level, right, S66.22_A Laceration of extensor at wrist and hand level, left, S56.42_A Laceration of extensor at forearm level, left, Flexor tendon sheath Irrigation and debridement 26020, M65.841 Other synvitis and tenosynovitis, right hand, M65.842 Other synvitis and tenosynovitis, left hand, S63.63_A Sprain interphalangeal joint right _finger, initial, S63.63_A Sprain interphalangeal joint left _finger, initial, Metacarpal Neck Fracture ORIF/ CRPP 26615, S62.336A- Displaced fracture of neck of fifth metacarpal bone, right hand, initial encounter for closed fracture, S62.337A- Displaced fracture of neck of fifth metacarpal bone, leftt hand, initial encounter for closed fracture, M19.041 Primary Osteoarthritis, right hand, Phalangeal Shaft Fracture S62.509A S62.609A, M19.041- Primary osteoarthritis, right hand, S63.511A Sprain carpal joint right wrist, initial, S63.512A Sprain carpal joint left wrist, initial, M19.042 Primary osteoarthritis of left hand, S63.114A Dislocation metacarpophalangeal joint right thumb, initial, S63.115A Dislocation metacarpophalangeal joint left thumb, initial, Thumb Ulnar Collateral ligament injury S63.649A, S63.641A Sprain metacarpophalangeal joint right thumb, initial, S63.642A Sprain metacarpophalangeal joint leftt thumb, initial, M19.031 Primary osteoarthritis, right wrist, M19.032 Primary Osteoarthritis, left wrist, Anterior Interosseous Nerve Syndrome G56.10 354.1, Carpal Tunnel syndrome (CTS) G56.00 354.0, Carpometacarpal Fracture - Dislocation S63.056A S62.109A S62.309A 833.04, Carpometacarpal Fracture-Dislocation CRPP 26676, Congenital Radioulnar Synostosis Q74.0 755.53, Distal Phalanx Fracture Open Treatment 26765, Distal Radioulnar Joint Arthritis M19.039 715.13, DRUJ Instability / Dislocation S63.016A 833.01, Extensor Carpi Ulnaris Subluxation S63.509A 842.00, Extensor Carpi Ulnaris Tendonitis M65.849 727.05, Extensor Tendon Injuries M66.249 S61.409A S66.929A 883.2, Flexor Carpi Radialis Tendonitis M65.849 727.05, Flexor Tendon Tenosynovitis M65.849 727.0, Giant Cell Tumor of the Tendon Sheath Images, Metacarpal Neck Fracture ORIF / CRPP 26615, Metacarpal Shaft Fracture S62.329A 815.03, Metacarpophalageal Joint Dislocation S63.116A 834.01, Phalangeal Base Fracture S62.509A S62.609A 816.00, Phalangeal Metacarpal Malunion/Nonunion S62.90XK 733.81, Phalangeal Neck Fracture S62.509A S62.609A 816.00, Phalangeal Shaft Fracture S62.509A S62.609A 816.00, PIP Fracture / Dislocation S63.279A 834.02, Radial Sided Wrist Pain Differential Diagnosis, Scaphoid Nonunion Advanced Collapse S62.023K 733.82, Scapholunate Advanced Collapse M19.039 715.13, Scapholunate Ligament Repair-Bruneli 25320, Thumb Basilar Joint Arthritis Classification, Thumb Basilar Joint Arthritis M19.049 715.14, Thumb Metacarpal Fracture S62.246A 815.03, Thumb Ulnar Collateral Ligament Injury S63.649A 842.12, Ulnocarpal Impaction Syndrome M24.839 718.83.

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