Perc pinning articular finger fracture

Hello-I know there is not a perc pinning code so I am thinking it should be billed as 26746 w/52 modifier. My doc wants to bill 26742 and 20650 however 20650 does have a separate procedure designation. Thoughts?  Thanks! Michelle


  • Per an AMA inquiry 26742-22 may be coded.
    Inquiry Question:
    The patient has an articular fracture of the metacarpophalangeal joint.  Reduction and percutaneous pinning is performed to treat the fracture.  Since there isn't a percutaneous pinning CPT code for this anatomical location should the coder report an unlisted CPT code or would it be appropriate to report 26742 - closed treatment of articular fracture?
    Response from: CPT KnowledgeBase 
    December 12, 2013
    This is written in response to your Electronic Inquiry. From a CPT coding perspective, based solely upon the facts provided in your electronic inquiry, and comments previously received from our CPT advisor, usually with an articular fracture you open it up to get correct alignment, which is why there is no percutaneous code for this but there is for a shaft fracture. Was it really intra-articular? If so, CPT code 26742, Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each, with a 22 modifier, Increased procedural service, appended should be reported. 
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