CPT® Code 20816

Replantation, digit, excluding thumb (includes metacarpophalangeal joint to insertion of flexor sublimis tendon), complete amputation

The procedure described by CPT® Code 20816 involves the replantation of a digit, specifically excluding the thumb, which has been completely amputated. This surgical intervention is performed at the level of the metacarpophalangeal joint, which is the joint connecting the finger to the hand. The replantation process is critical for restoring function and appearance to the hand following a traumatic amputation. During the procedure, the patient is placed under general anesthesia to ensure comfort and immobility. The surgeon meticulously removes any damaged or necrotic tissue to prepare the site for reattachment. The ends of the amputated bones are then trimmed to facilitate a more precise alignment during rejoining. This careful preparation is essential for the subsequent suturing of soft tissues, including arteries, veins, nerves, muscles, and tendons, which are all crucial for the digit's functionality. In cases where there is a lack of skin coverage, a graft may be utilized to cover the exposed areas. Additionally, any uncovered nerves, tendons, and joints may require a free-tissue transfer, which includes the necessary blood supply through its associated artery and veins. Finally, the surgical site is closed in layers to promote optimal healing and restore the integrity of the hand.