CPT® Code 26951

An amputation of the finger or thumb, as described by CPT® Code 26951, involves the surgical removal of all or part of the digit due to various medical conditions such as severe trauma, infection, or malignant tumors. This procedure can be performed at different anatomical levels, specifically at the interphalangeal (IP) joints, which are the joints between the phalanges, or at the metacarpophalangeal (MCP) joint, which connects the finger to the hand. The amputation may also occur through one of the phalanges, the long bones in the fingers. The surgical process begins with a skin incision made at the predetermined level for the amputation. Following the incision, the surrounding soft tissues are carefully dissected to expose the joint or phalanx that is to be removed. During the procedure, tendons may need to be detached or divided and subsequently reattached to the remaining bone to maintain functionality of the adjacent structures. Additionally, digital nerves are addressed through a technique known as traction neurectomy, where the nerve ends are longitudinally distracted and transected, allowing them to retract proximally. This technique minimizes the risk of neuroma formation by ensuring that the nerve ends are positioned away from the amputation site. Blood vessels are also managed by being suture ligated and divided or cauterized to control bleeding. If the amputation occurs at a joint, the joint structures are dissected, and the finger is completely severed, while the articular cartilage is preserved on the remaining bone to cushion it. In cases where the amputation is through a phalanx, a small bone saw is utilized to cut the bone, and the end is smoothed to prevent sharp edges. Finally, the soft tissues overlying the amputation site are closed in layers to promote healing and minimize complications.