Summary & Overview
CPT 26562: Separation of Congenitally Joined Fingers (Syndactyly Release)
CPT code 26562 denotes surgical separation of congenitally joined fingers (syndactyly release) with bone division or excision and nail bed/nail fold reconstruction. This reconstructive hand surgery code is clinically important for restoring digit function and appearance in pediatric and adult patients with congenital fusion. Nationally, the code is relevant for surgical specialty billing, payer coverage policies for congenital hand anomalies, and perioperative quality measurement.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes common billing considerations, typical sites of service, and the clinical context for use of the code.
Readers will find benchmarks and comparative notes on utilization and reimbursement practices, an overview of clinical indications and procedural components, and any recent policy updates affecting coverage or documentation expectations. The content also outlines coding relationships and documentation essentials to support claims when performing syndactyly release in appropriate clinical settings. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 26562 describes surgical separation of congenitally joined fingers (syndactyly release) by incising between the digits. The procedure includes division (osteotomy) or excision of bone and release of fused nail beds with nail fold reconstruction.
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Service type: Surgical reconstructive procedure of the hand/fingers for congenital syndactyly
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Typical site of service: Operating room or ambulatory surgical center, often performed by hand surgeons or pediatric orthopedic/plastic surgeons
Clinical & Coding Specifications
Clinical Context
A 6-month-old infant is brought to a pediatric hand surgeon for evaluation of congenital syndactyly of the third and fourth fingers of the right hand causing fused soft tissue and nail beds with partial bony connection. Preoperative assessment includes history, physical exam, and hand radiographs to delineate bony fusion. The patient is scheduled for operative separation under general anesthesia in an ambulatory surgery center. Intraoperative steps include incising the web space, performing osteotomy or excision of fused bone where indicated, releasing the fused nail beds, and reconstructing the nail folds and skin flaps for adequate coverage. Tourniquet control and microsurgical technique may be used. Postoperative care includes dressing, splinting, pain control, wound checks, and hand therapy as indicated. Typical documentation elements include laterality, extent of bony involvement, exact reconstruction performed, estimated blood loss, anesthesia type, and any intraoperative complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Co-surgery | When two surgeons of different specialties simultaneously perform distinct parts of the procedure (e.g., plastic surgeon and orthopedic hand surgeon). |
66 |