CPT® Code 20527

Dupuytren's contracture is a condition characterized by the thickening and tightening of the palmar fibrous tissue, which occurs due to an excessive deposition of collagen beneath the skin of the hand and fingers. This condition is typically painless; however, the resultant thickening leads to a flexion contracture, making it challenging or even impossible for the affected individual to fully extend one or more fingers. The procedure associated with CPT® Code 20527 involves the injection of an enzyme, such as collagenase, directly into the palmar fascial cord. This enzyme acts to weaken the fibrous cords that have formed, thereby facilitating the subsequent manipulation of the hand and fingers. The use of ultrasound may be employed to visualize the soft tissues of the hand, allowing for the precise identification of the flexor tendon. It is crucial to measure the depth from the skin to the surface of the flexor tendon to avoid accidental injection into the tendon itself, as the injection should be limited to the fibrous tissue cords. Following the injection, the patient is scheduled to return the next day for a separate procedure that involves the manipulation of the hand and mechanical breakage of the cord, which aims to straighten the fingers and restore functionality.