CPT® Code 26565

An osteotomy of the metacarpal bones is a surgical procedure aimed at correcting deformities or realigning the bones of the hand. The term "osteotomy" refers to the surgical cutting of bone, and in this case, it specifically pertains to the metacarpal bones, which are the long bones in the hand that connect the wrist to the fingers. The procedure is tailored to the specific type and location of the deformity, which may vary from patient to patient. Various techniques can be employed during the osteotomy, including transverse cuts, wedge-shaped cuts, sliding cuts, and angular cuts, such as right or left angle, V-osteotomy, and Z-osteotomy. Before the surgery, the physician utilizes radiographic studies to precisely determine the optimal location and configuration for the bone cut, ensuring that the procedure will effectively address the deformity. During the operation, an incision is made over the affected metacarpal bone or phalanx, allowing access to the bone after careful dissection of the surrounding soft tissues. The periosteum, a dense layer of connective tissue that covers the bone, is elevated to expose the bone surface. Using surgical instruments such as drills, saws, or osteotomes, the surgeon then makes the necessary cuts in the bone according to the pre-determined plan. In some cases, bone grafts may be inserted between the cut segments to promote healing and stability. To secure the bone in its new position, various fixation methods may be employed, including pins, screws, or plates. Alternatively, an external fixation device may be used if deemed appropriate. It is important to report the procedure using the appropriate CPT® code, specifically 26565 for each metacarpal bone treated with osteotomy, while 26567 is designated for osteotomies of the phalanx.