26040
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
3.37
Facility
$308.62
Non-Facility
$308.62
Key Coverage Criteria
- Surgical treatment for Dupuytrenâs contracture is consideredmedically necessarywhen a palpable palmar cord has been documented to impair the individualâs functional activitiesandany of the following:
- Contracture at the proximal interphalangeal (PIP) joint or distal interphalangeal (DIP) joint of 20 degrees or more;or
- Contracture at the metacarpophalangeal (MP) joint of 20 degrees or more;or
- Symptomatic Dupuytrenâs contracture (that is, pain, tenderness, or functional impairment).
1 Active Policy
ANTHEM-CG-SURG-11 — CG-SURG-11 Surgical Treatment for Dupuytren's Contracture
Related Codes
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