Summary & Overview
CPT 26045: Open Palmar Fascia Release for Dupuytren's Contracture
CPT code 26045 covers an open incision of the palmar fascia to treat Dupuytren's contracture, a condition that leads to progressive hand contractures and impaired finger extension. Nationally, this surgical code is relevant for orthopedics, hand surgery, and plastic surgery providers managing functional impairment from palmar fibromatosis. The code delineates a definitive open-release procedure as opposed to percutaneous or injectable alternatives, and it informs surgical coding, payment, and utilization tracking across outpatient and inpatient surgical settings.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn clinical context for the procedure, common sites of service, and typical service line placement; an overview of common modifiers used with surgical codes; and what to expect in claims processing and payer coverage considerations at a national level. The publication summarizes benchmarking approaches and policy considerations relevant to surgical management of Dupuytren's contracture, while clarifying where input data are available or not.
Data not available in the input: Associated taxonomies, specific ICD-10 diagnosis pairings, related CPT codes, and payer-specific reimbursement rates.
Billing Code Overview
CPT code 26045 describes an open surgical procedure in which the provider incises the palmar fascia, the connective tissue beneath the skin of the palm. The operation is performed to release contractures associated with Dupuytren's contracture, a progressive fibrosing condition that can cause permanent bending of the fingers and impair hand function.
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Service type: Open surgical fasciectomy or fasciotomy of the palm performed to release Dupuytren's contracture
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Typical site of service: Outpatient surgery center or hospital operating room; procedure may also occur in an ambulatory surgical setting depending on clinical needs and facility capabilities
Clinical & Coding Specifications
Clinical Context
A typical patient is a 60-year-old male with progressive flexion contractures of the ring and small fingers of the dominant right hand, causing difficulty with grasp, hygiene, and activities of daily living. Conservative measures including occupational therapy and night splinting failed to halt progression over several months. Physical exam shows palpable palmar cords and a PIP and MCP joint contracture consistent with Dupuytren's contracture. The hand surgeon schedules an open palmar fasciectomy/contracture release under regional block with monitored anesthesia care. Preoperative workflow includes history and physical, informed consent discussing risks (infection, neurovascular injury, recurrence, stiffness), medication reconciliation, and pre-op photos/measurements. Intraoperative steps include sterile prep, incision over the palmar cords, careful dissection to identify and excise contracted palmar fascia, protection of digital nerves and arteries, possible limited fasciectomy of cords into the digits, and wound closure with or without local flap or skin graft if needed. Postoperative workflow includes dressings and immobilization, hand therapy referral for edema control and range-of-motion, pain management, and follow-up for suture removal and monitoring for complications. Typical site of service is an ambulatory surgery center or hospital outpatient surgical suite. The service type is a surgical, open procedure for correction of Dupuytren's contracture, coded with 26045 for incision of palmar fascia (open fasciectomy/contracture release).
Coding Specifications
| Modifier | Description | When to Use |
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