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synonyms:metatarsal fracture ORIF, open treatment metatarsal fracture, Metatarsal Fracture ORIF Contraindications, Metatarsal Fracture ORIF Review References, Site Terms | Copyright Information | ContactUs | Site Registration. You will wear your splint at all times for 4-6 weeks. Metatarsal Fracture ORIF Contraindications. <> Diagnosis is made by orthogonal radiographs the hand. 1995-2023 by the American Academy of Orthopaedic Surgeons. Metacarpal Fractures are the most common hand injury and are divided into fractures of the head, neck, or shaft. The information on this website may not be complete or accurate. The bone utilized for the case in question is an allograft. If you have an arm fracture, you may go home later that day. Under fluoroscopic guidance, the surgeon was able to manipulate the bone to create an ample reduction. Thanks for replying Tonya. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Epub 2021 Jul 15. After reading Surgical Modifier Application during the Global Period (AAOS Now, March 2013), we researched our private payer contracts and found that they all follow Medicares surgical package rules. For a smooth recovery, heres what you can do at home: Its important to attend all your checkups after surgery. He places two titanium screws to s. Both fractures were non displaced and the hand surgeon applied a short arm cast. Is this correct? ORIF is performed by an orthopedic surgeon. Healthline Media does not provide medical advice, diagnosis, or treatment. If plate is not pre-bent the volar cortex will gap open when the plate is secured. S62.337A- Displaced . You must log in or register to reply here. The surgery is used to fix fractures in the arms and legs, including bones in the shoulder, elbow, wrist, hip, knee, and ankle. After ORIF ankle surgery, you wont be able to walk for some time. Metacarpal Fractures: Practice Essentials, Anatomy, Pathophysiology Correction of a misalignment of the broken bones involves making an incision and aligning the broken bones back into place. CPT code 28615 would be reported for the fixation of the dislocation. 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) The patient was in an automobile accident and sustained an open fracture of the left femur. It may not display this or other websites correctly. Both fractures were non displaced and the hand surgeon applied a short arm cast. Base of Thumb metacarpal fractures can be extra-articular fractures, Bennett fractures (partial intra-articular), or Rolando fractures (complete intra-articular). VEPTR insertion This will let your doctor monitor your healing process. Here, we highlight eight frequently encountered errors when coding hand procedures and how to fix them. 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. This column addresses recently asked questions on coding orthopaedic procedures. 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. The first part is open reduction. The insertion is reported with an unlisted spine code, 22849. Fracture Management - an overview | ScienceDirect Topics These fractures tend to be unstable, and bone healing is often prolonged. The fractures were angulated and the fingers were not aligned well. Please log in to access this article. PDF Case Log CPT Codes - Department of Orthopaedic Surgery Are you looking for more than one billing quotes? Closed reduction and percutaneous pinning is commonly used for low-energy metacarpal shaft and neck fractures (Figs. See answer (1) Copy. Cpt Code For Orif Fibula Fracture. Or lateral CPT 24358 - How do we report this procedure? Thanks for bring that to my attention PLASTICSCPT, I only went by the Cpt book and it does not address what type of bone donor, it only said, any donor, so after I read your message, I went on my Ingenix program and looked at the Lay terminology definition and saw Autograft. This website and its contents may not be reproduced in whole or in part without written permission. Metatarsal Fracture Fixation | Open Reduction | Internal Fixation 35-1 and 35-2 ). 3 0 obj Open reduction and internal fixation of metacarpal fractures using a 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. [26] Metacarpal Neck Fracture ORIF Follow-up care. Site Terms | Copyright Information | ContactUs | Site Registration. There are several types of humerus fractures, depending on the location of the. This procedure requires general anesthesia (you'll be asleep . Michael J. Garcia, MD, (Tampa, FL) presents metacarpal fracture fixation using an intramedullary, partially threaded Compression PT Screw. registered for member area and forum access. Depending on the nature of the fracture, the bones may be repositioned surgically or without surgery. Two days later, the patient was returned to OR and the dressing was removed. A Potpourri of Coding Questions - American Academy of Orthopaedic Surgeons All Rights Reserved. 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. Antegrade intramedullary splinting or percutaneous retrograde crossed This patient sustained displaced fractures of the fourth and fifth metacarpal shafts. What is the cpt code for ORIF for right 5th metacarpal? Depending on your surgery, you may go home that day or you might stay in the hospital for one to several days. Open Reduction and Internal Fixation (ORIF) involves fixing severely broken bones and placing them back together using pins, plates, or screws. I reviewed CPT 20900 but thought not to bill because it states 'autogenous' bone graft/harvest. Place in removable splint with fingers buddy-taped. Bennett fragment>20% of the articular surface:ORIF. (2012). If plates and screws require removal in the future, this will require an additional surgery. eyNNrX 'Rv&5a`JQ7>;xb3&'l. Injury to the metacarpal head may have a severe effect on hand function but few studies have investigated the management of this condition. Anatomy for Hand Fracture Management. Screw Fixation. For the debridement of an open fracture includes only skin and subcutaneous tissue, use code 11010; debridement down to the muscle fascia and muscle, code 11011; and debridement that includes skin, muscle fascia, muscle, and bone, code 11012. 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) For private payers, who should be applying CPT rules, you should report the meniscal repair and the chondroplasty code 29877 with modifier 59 appended when the chondroplasty is performed in a different compartment than the meniscal repair. Remember, you can direct specific coding questions to the AAOS for review by the Coding, Coverage, and Reimbursement Committee and AAOS staff. Ensure screw purchase in 4 cortices (2 plate holes) on both sides of the fracture, Consider cancellous bone graft from proximal ipsilateral ulna, distal radius, or iliac crest if needed. See Site Terms / Full Disclaimer. Closed reduction internal fixation rates and procedure times for However, a subset of metacarpal shaft or neck fractures cannot be reduced by closed means or are unstable after reduction. You will follow up with us in the office 1-2 days after the procedure. Lost revenue and costs exceed 10 billion dollars. The area was then copiously irrigated, and a dressing was placed. The main goal of our organization is to assist physicians looking for billers and coders. 3 Months: Check xrays. ORIFF/CRPPsurgical and non-surgical approaches to resetting bones. It is not intended for the general public. When we queried why only one fracture care was paid, our Medicare Metacarpal Neck Fracture ORIF/ CRPP 26615. ORIF of First Metacarpal Base Fracture - Acumed 26615Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone, 26605Closed treatment of metacarpal fracture, single; with manipulation, each bone. 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. This will put you in a deep sleep during the surgery so you wont feel any pain. If you have a leg fracture, you might have to stay longer. The bone allograft is supplied by the facility so the physician cannot bill for it. A: After joint reconstruction, joint injections for pain management and aspiration of an effusion in the operated joint are not considered separately reportable by Medicare. Above mentioned codes only report debridement of open fractures and dislocations. They should not be used to report minor debridement or the normal care that would be taken with an open fracture, such as minor excision of the wound edges (skin margin) necessary to close the defect. Bennett Fractrue ORIF CPT. Once your bones begin to heal, your doctor may have you do physical or occupational therapy. Several years ago, CMS implemented NCCI guidelines instructing that non-manipulative fractures that are . Metacarpal Head Fractures ORIF - Hand - Orthobullets 6 Weeks: Check xrays. After ORIF, doctors and nurses will monitor your blood pressure, breathing, and pulse. Ankle fracture open reduction and internal fixation. Conversely, this strategy is also well suited for stabilizing simple comminuted fractures and fractures associated with moderate to severe soft tissue injury. The Center for Medicare and Medicaid Services (CMS) via the National Correct Coding Initiatives (NCCI) published Medicare payment rules for Part B Medicare. Metacarpal neck fracture left icd-10. -"e splint may be cut down to hand-based only at 4 weeks. The splint will gradually be discontinued in the weeks to follow as you progress with occupational therapy. 2021 Jul;48 (4):384-388. doi: 10.5999/aps.2021.00122. (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. 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. The information on this website may not be complete or accurate. Dorsal longitudinal incision over affected metacarpal. This is rare. endobj An external fixator device was used, and a dressing was applied to the open area. 15 blades to bleeding tissue. Debridement is used to promote healthy healing of damaged skin, tissue, muscle, or bone. 2012 ICD-9-CM Procedure 79.* : Reduction Of Fracture And Dislocation It's common in athletes and people who try to do too much activity too quickly. Internal fixation allows for anatomical reduction, early active motion and shorter rehabilitation. Fractures Question: "The emergency de-partment referred me a patient with three non-displaced metatarsal frac-tures right foot. How to Avoid Common Mistakes When Coding Hand Procedures Surgery: Correction of a misalignment of the broken bones involves making an incision and aligning the broken bones back into place. synonyms: Bennett fracture, thumb fracture, thumb metacarpal fracture ORIF. 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. Perform gentle range of motion activities of the fingers. Emergency departments usually have a high inflow of patients with hand injuries, and metacarpal fractures represent around half (40%) of these hand injuries [1, 2].Metacarpal fractures often comprise a large proportion of all hand fractures and fractures below the elbow, particularly in industrialized environments such as the USA [2,3,4].Either accidental falls or direct impact trauma is . Q: The podiatrist in our office recently performed an arthrodesis procedure that required bone graft to be harvested from the iliac crest. How to Increase Revenue of Behavioral Health Practice? Learn what to expect for treatment and recovery. Open reduction internal fixation (orif) is a surgery to fix severely broken bones. A: AMA CPT rules describe codes 26615 and 26605 as follows: 26615Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone; 26605Closed treatment of metacarpal fracture, single; with manipulation, each bone If an open fracture or dislocation is not present, use a. All bony prominences well padded. S62.336A- Displaced fracture of neck of fifth metacarpal bone, right hand, initial encounter for closed fracture. Open Reduction and Internal Fixation (ORIF) involves fixing severely broken bones and placing them back together using pins, plates, or screws. Displaced MC shaft fracture (angulation >30 degrees, shortening >4mm, any rotational deformity). 26650. Open reduction internal fixation (ORIF) is a surgery to fix severely broken bones. courthouse marriage near me - changing-stories.org Q: The results of our internal coding audit surprised our surgeons, who learned that they cannot report a chondroplasty with a meniscal repair when the chondroplasty was performed in a different compartment. Our new hand surgeon evaluated a patient with a base of the fifth metacarpal fracture and distal radius fracture. Open reduction internal fixation (ORIF) is a surgical approach that's used for repairing certain types of bone fractures. As with any surgery, there are potential risks and side effects associated with ORIF. Multiple Fractures: One code or multiple? - KarenZupko&Associates, Inc. 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). Most metacarpal fractures occur in the active and working population, particularly adolescents and young adults. Information in this article has been reviewed by members of the AAOS Coding, Coverage, and Reimbursement Committee. bone allograft | Medical Billing and Coding Forum - AAPC The information on this website is intended for orthopaedic surgeons. These problems are rare. Preserve the vascular supply that enters through the dorsoradial ridge. Ambulance Transportation Billing Services, Skilled Nursing Facilities Billing Services. 2008-2023 eORIF LLC. Open reduction and internal fixation (ORIF) surgery with plates and screws was performed and range of motion with hand therapy was begun early. 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. Podiatric bone graft While the information on this site is about health care issues and sports medicine, it is not medical advice. Nevertheless, it . These injuries are usually fractures that are displaced, unstable, or those that involve the joint. Prospectively collected data of 25 consecutive patients were evaluated retrospectively, assessing stability of fixation, operation time and the occurrence of fracture dislocation during and . Orthobullets Team % TECHNIQUE VIDEO 0 % TECHNIQUE STEPS 0. Encourage gentle ROM. 2012 ICD-9-CM Procedure 79. Wrist/Hand | eORIF At surgery the following day an open reduction and internal fixation (ORIF) of the left fifth metacarpal head fracture was performed. The surgery is used to fix fractures in the arms and legs, including bones in the shoulder, elbow, wrist, hip, knee, and ankle. They are described by the appearance of their respective fracture patterns and can be divided by transverse, oblique, spiral, and comminuted. The audit stated that Medicare has a zero modifier with the 29877 code, indicating that the meniscal repair also includes the chondroplasty. The countdown to AAOS 2023 March 7-11 in Las Vegas is on! Metacarpal Fracture with ORIF 1160 Kepler Drive 1 | Page Green Bay, WI 54311 920-288-5555 . Be sure to follow CPT coding rules and the AAOS Complete Global Service Data for Orthopaedic Surgery when reporting all services. The intramedullary absorbable implants are a safe, simple, and practical treatment for fourth and fifth metacarpal fractures with good early clinical outcomes and no significant complications. Progress with ROM exercises. CPT Codes for Hand and Finger Fractures: ICD Counterpart Codes: Closed Treatment without Manipulation: Closed Treatment with Manipulation: Closed Reduction with External Fixation: Percutaneous Pin Fixation: Open Reduction with or without Fixation: Metacarpal: Bennett: Phalangeal Shaft, Proximal / Middle: 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. 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. The type of hardware used depends on the location and type of fracture. Metacarpal Fractures Pathway Updated: 10/4/2016. You may be correct if the payor is Medicare and hence the confusion sets in. If union is complete return to full activities. Despite the increasing success rate of ORIF, recovery depends on your: ORIF is performed by an orthopedic surgeon. Diagnosis can be made by orthogonal radiographs of the thumb. Metacarpal fractures are among the most common hand injuries, often caused by a direct blow to the hand or by axial load. He was treated with a Rolando Fracture Hook Plate from the Acumed Hand Fracture System. Metatarsal Fracture ORIF 28485 | eORIF WEEKS 0-1: Remain in post-operative hand splint. stream Metacarpal Neck Fracture ORIF / CRPP 26615 | eORIF 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. when performing an ORIF of metacarpal fracture with the use of bone allograft, is the bone allograft separately reportable and if so, what code should be billed? While extra-articular fractures are mostly seen independent of other injuries, intra-articular fractures can present with concomitant carpometacarpal joint dislocation, especially in the ring and small fingers. After 48 hours you may shower. 4 0 obj You can learn more about how we ensure our content is accurate and current by reading our. It's paid for under the resources used by the facility. (n.d.). Bennett fragment < 20% of the articular surface: CRPP. ORIF isnt for minor fractures that can be healed with a cast or splint. Hand Injuries - Finger Tip Injuries, Jersey Finger, PIP Dislocations Metacarpal Fractures and Dislocations Treatment & Management Updated: Jan 19, 2023 Author: James Neal Long, MD, FACS; Chief Editor: Joseph A Molnar, MD, PhD, FACS more. Prep and drape in standard sterile fashion. While showering, you may use soap and water, but be sure to pat the incision dry. Description of potential complications and steps to avoid them . Epidemiology Incidence It may also involve the surrounding neurovascular structures, ligaments, and/or tendons, or involve dead or devitalized tissue, hemorrhaging, or swelling. Loading. PDF Metacarpal or Phalanx (ORIF) Open Reduction and Internal Fixation 2008-2023 eORIF LLC. It is not intended for the general public. In such cases, you should accurately report all of the work involved. The orthopaedic surgeon did not assist on any part of the procedure other than the associated bone graft work. In some instances, when bones can be easily manipulated to correct alignment, Closed Reduction and Internal Fixation may be done and no incision will be made in affected finger/hand. It is not intended for the general public. %PDF-1.5 Reduction of the the displaced scaphoid is the first step prior to screw fixation, using a double-pitch headless screw. Open treatment refers to the . This surgery is performed on an outpatient basis meaning you will be able to go home that day. View a chart showing the last 8+ years of Medicare denial rates, Medicare Allowed amounts, and Medicare billed amounts. The arthrodesis code does not include the harvest of bone graft in its description so I dont think this is cosurgery. Open Reduction Of Fracture With Internal Fixation, Carpals And Metacarpals. "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. 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 . Often the wound site is contaminated with foreign material (e.g., grass, twigs, dirt, oil, grass, gravel, etc) and bacteria. Place in removable splint with fingers buddy-taped. Who is right? "All Rights Reserved." Bennett Fractrue ORIF Indications. Pre-bend plate with gradual 5 degree contour over the entire length of the plate. 1st metacarpal base intra-articular fracture (below). Surgical Fixation of Fourth and Fifth Metacarpal Shaft Fract - LWW Coding additional procedures can boost your bottom line by $500. What is the cpt code for ORIF for right 5th metacarpal? The surgeon will cut the skin and move the bone back into the normal position. The goals for hand therapy following a metacarpal or phalanx open reduction and internal fixation (ORIF) is to regain full range of motion, decrease pain, progress to strengthening activities and return to functional activities. Teaching video It is important to elevate your arm on a couple of pillows to alleviate pain and swelling. The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care". Metatarsal Fracture ORIF Indications. It is important that you do not submerge your surgical incision in water (i.e. Dr. Hand reports one CPT code if this patient was Granny, who has Medicare Part B coverage. 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.