CPT 26341: Post-Injection Finger Manipulation for Dupuytren's Contracture
CPT code 26341 denotes a manual manipulation procedure applied to a finger that remains bent after treatment for Dupuytren's contracture, performed on a different day after enzymatic injection into the palmar fascial cord. This code captures a distinct post-injection service that can affect patient outcomes and billing classification for hand surgery and office-based procedures. Nationally, accurate use of this code matters for appropriate claims adjudication, resource tracking for ambulatory surgical and office settings, and consistent clinical documentation of staged treatment for Dupuytren's disease.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for staged enzymatic treatment of Dupuytren's contracture, guidance on where the service is typically delivered, and what to expect when CPT code 26341 is submitted alongside the preceding enzymatic injection code. The publication also outlines common modifiers associated with this billing scenario, highlights policy considerations that influence reimbursement and claims processing, and identifies benchmarks and coding touchpoints relevant to hand surgeons, procedure-based clinicians, and billing teams. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 26341 describes a manual procedure in which a provider applies controlled force to a finger that is bent by a condition such as Dupuytren's contracture. The service is performed on a different day following an enzyme injection into the palmar fascial cord used to treat the contracture.
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Service type: Procedure involving manual manipulation of a finger after enzymatic fascial cord disruption
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Typical site of service: Ambulatory surgical center or office procedure setting where follow-up manipulation after injection is performed
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old man with progressive palmar fascial contracture (Dupuytren's disease) causing a flexion deformity of the ring finger at the proximal interphalangeal joint. The patient previously received an outpatient collagenase clostridium histolyticum injection into the palmar fascial cord on a separate day. After a waiting period and documented improvement in cord softening, the patient returns to the clinic for a planned manual cord rupture and finger extension. The procedure is performed in an ambulatory clinic or physician office setting by a hand surgeon or orthopedic/plastic hand specialist. The workflow includes pre-procedure consent and exam, confirmation of prior enzyme injection in the chart, local anesthesia (digital block) as needed, controlled manual manipulation to release the cord and restore extension, post-procedure neurovascular check, wound and skin tear management if present, and brief monitored observation prior to discharge with instructions for hand therapy or splinting as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service on the same day | Use if a distinct E/M visit is provided on the day of the manipulation and is properly documented. |
52 | Reduced services | Use when the manipulation is partially reduced or abbreviated for clinical reasons. |
53 | Discontinued procedure | Use if the manipulation was started but then discontinued due to patient intolerance or complication. |
59 | Distinct procedural service | Use to indicate a separate procedural service when multiple procedures are performed on the same claim and not normally reported together. |
73 | Discontinued outpatient hospital/ASC procedure prior to anesthesia administration | Use if the manipulation was scheduled in ASC/hospital and cancelled after patient arrival but before anesthesia. |
78 | Unplanned return to OR/procedure by same physician following initial procedure for a related procedure during the postoperative period | Use if an unplanned repeat manipulation is required during the global period. |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when a procedure unrelated to the original operation is performed during the global period. |
LT | Left side | Use to designate left hand or finger when laterality is required. |
RT | Right side | Use to designate right hand or finger when laterality is required. |
62 | Two surgeons | Use if two surgeons collaborate and both perform distinct portions of the manipulation. |
22 | Increased procedural services | Use if additional work beyond usual is documented (e.g., complex release, extensive skin management). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207RH0000X | Hand Surgery (Orthopedic) | Orthopedic hand surgeons commonly perform manual fascial cord release after enzyme injection. |
207XS0101X | Plastic Surgery (Hand) | Plastic surgeons with hand specialization manage complex palmar fascial disease and perform manipulations. |
207RA0000X | Orthopedic Surgery | General orthopedic surgeons with hand expertise may perform this procedure in outpatient settings. |
2080P0201X | Family Medicine | Some family medicine physicians with procedural competencies in hand care may perform office-based manipulations. |
341600000X | Physical Medicine & Rehabilitation | PM&R may participate in pre- and post-procedure management and splinting but rarely perform the manipulative release itself. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M72.0 | Palmar fascial fibromatosis [Dupuytren] | Primary diagnosis indicating Dupuytren contracture treated by collagenase injection followed by manual rupture. |
M24.4 | Recurrent dislocation and subluxation of joint | Not directly related; Data not applicable—see core Dupuytren code above. |
M67.4 | Ganglion of tendon sheath | Not a typical indication for this procedure; included for completeness when hand procedures coexist. |
S62.9 | Fracture of wrist and hand, unspecified | Not a typical indication but may be present as a comorbidity affecting treatment planning. |
M25.5 | Pain in joint | Symptom code that can accompany hand contractures and justify evaluation and therapy. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
26340 | Manual disruption (rupture) of palmar fascial cord, single finger (without injection) | Closely related procedural technique; 26341 specifically follows enzyme injection on a different day. |
20550 | Injection, therapeutic (e.g., local anesthetic), single tendon sheath, or ligament | Used for local anesthetic or steroid injection into tendon sheath if required for pain control during manipulation. |
20552 | Injection, therapeutic, multiple tendon sheaths, or single ligament | Used when multiple injections are necessary in the hand during procedural care. |
12001 | Simple repair of superficial wounds of face, ears, eyelids, nose, lips; 2.5 cm or less | May be used for small skin laceration repair if skin tears occur during manipulation. |
26055 | Trigger finger release, percutaneous, one or more digits (separate procedure) | Represents other finger-release procedures that may be performed in the same practice; distinct from Dupuytren contracture manipulation. |
97001 | Physical therapy evaluation | Represents pre- or post-procedure hand therapy evaluation commonly used in the rehabilitation plan following manipulation. |