CPT® Code 26510

The procedure described by CPT® Code 26510 refers to a surgical technique known as cross intrinsic transfer, which involves the manipulation of the tendons of the intrinsic muscles of the hand. The intrinsic muscles are those that are located entirely within the hand and are responsible for fine motor movements, including the coordination and control of the fingers. These muscles are categorized into four distinct groups: the thenar muscles, which control thumb movements; the hypothenar muscles, which manage movements of the small finger; the lumbricals, which assist in flexing the metacarpophalangeal joints while extending the interphalangeal joints; and the interossei, which are responsible for abduction and adduction of the fingers. The cross intrinsic transfer procedure specifically targets the interosseous muscles, which play a crucial role in finger stability and movement. This surgical intervention is primarily indicated for patients suffering from ulnar drift, a condition often associated with severe rheumatoid arthritis, where the fingers deviate towards the ulnar side of the hand. During the procedure, an incision is made on the finger to expose the interosseous muscle. The tendon on the ulnar side of the finger is carefully freed from its attachments, allowing the surgeon to reroute it across the web space to the radial side. This rerouting is essential for restoring proper alignment and function of the fingers. The tendon is then anchored to either the radial extensor hood or the radial collateral ligament of the adjacent finger, thereby providing enhanced radial stability. Each tendon transferred during this procedure is reported separately, reflecting the complexity and specificity of the surgical intervention.