American. 0. [20], with additional interruption of the anterior interosseous nerve (AIN). Jan 25, 2017. The VAS pain score decreased from an average of 7. Metacarpophalangeal dislocation, closed (834. Injections for other tendon origin/insertions. The new evidence has come in recent years, assuring the antihypertensive effect of RDN. 1. Denervation of the first CMC joint is a relatively new procedure for managing stable thumb CMC. Carpal bone dislocations: an analysis of twenty cases with relative emphasis on the role of crushing mechanisms. Files related to Debridement; skin, subcutaneous tissue, and muscle (11043) Find Window. }, author={Raymond Rath and Max Haerle. 008 Corpus ID: 253927867; Denervation of the thumb carpometacarpal joint for symptomatic osteoarthritis in 46 patients. 2. 0 cm (12046)Article Guidance. " D. A57826 - Billing and Coding: Facet Joint Interventions for Pain Management A58658 - Response to Comments: Facet. 9, 10, 11 Cadaveric. Objective. Your symptoms may not go away. A CMC arthroplasty was performed along with excision of the trapezoid bone. Other patients may be better served with a vasectomy reversal, conversion to an open-ended vasectomy, excision of a sperm granuloma, or epididymectomy. ICD-10 Codes Description K11. A review of four cases. 2011;8:22–31. 90 cm from the Listers tubercle. Release Skin / Fascia; Release Tendon / Muscle; Release Joint; Contractures Basal joint / First web space; Boutonniere; Burn; Dupuytren'sFrom AMA CPT 2020: “For bilateral paravertebral facet injection procedures, report 64490, 64493 with modifier 50. ablation or denervation is an effective treatment for occipital neuralgia or headaches. Common Topics: Amputations; Arthritis; Arthroplasty; Aspirate / Inject; Basal Joint; Burns; CTS / Pronator; Collagen Vasc; Congenital; Contractures; Contusion. 1016/j. 04 closed or 833. All VT episodes occurred in the first 4 months after ablation (2. cclarson Guru. Carpometacarpal joint denervation is a relatively novel method for managing CMC arthritis, treating the most impactful symptom: pain. Dissection was down through skin and subcutaneous tissue, protecting any nerves and arteries, and the small branching vessels were cauterized. The thenar eminence is composed of three muscles that control the movements of the thumb: abductor pollicis brevis (APB), flexor pollicis brevis (FPB), and the opponens pollicis. the hemitrapeziectomy is an arthrodesis of the 1st CMC which my. 11. Methods In this paper, we present a 4- to 6-year follow-up case. Sixteen case series reported positive outcomes with respect to pain, function and patient satisfaction. 01) Metacarpal base fracture, closed (815. 2018. 6 months, pain was reduced from mean of 8. 5 months). Introduction. Title XVIII of. 1016/j. 25% bupivacaine. 2 percent of men with this problem. The present. FEP 7. X. Denervation procedures have been shown to be a valid option in other joints: e. second level (list separately in addition to code for primary procedure)from publication: Volar denervation and osteophyte resection to relieve volar CMC joint pain | At mean 125. 1 The socioeconomic burden of OA is high, at least 4. thanks for the imput. Wrist denervation is a safe and effective procedure for the treatment of chronic wrist pain that can delay or eliminate the need for salvage or anatomically distorting procedure, such as proximal row carpectomy. Background: Pain reduction as well as preservation and improvement in range of motion remain the main aims in the treatment of thumb carpometacarpal (CMC) osteoarthritis (OA). The main function of abductor pollicis brevis is the abduction of the thumb at the carpometacarpal joint. Renal denervation did not result in any significant long-term increase in renal artery stenosis or worsening of renal function. Rather, the provider of these therapies must bill with CPT code 64455 or 64632 Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (eg, Morton's neuroma) as the correct CPT code for the service. High revision rates with the metal-on-metal Motec carpometacarpal joint prosthesis. Surgery. Trapeziectomy with suspensionplasty is the most popular treatment for thumb carpometacarpal arthritis. 25447 Includes Trapezium Excision. Purpose To determine the innervation pattern to the thumb carpometacarpal (CMC) joint and assess the safety and efficacy of selective joint denervation for the treatment of pain and impairment associated with thumb CMC arthritis. Botulinum toxin type A (Botox®) (onabotulinumtoxinA), is supplied in 100-unit vials, and is billed “per unit. 6 cm to 12. The chart below identifies which trade name. 2018. Arthroplasty, Carpometacarpal (CMC) Joint, Thumb Arthroplasty, Metacarpophalangeal (MCP) Joint, Digits. Long-term follow-up after ligament reconstruction with tendon interposition. Straightforward – 10 minutes: 99212. To apply the principles of therapeutic joint denervation to treat thumb CMC arthritis, a basic understanding of the innervation patterns to the CMC joint is needed. Objective. hansur. 7 Disturbances of salivary secretion R68. 3) Late effect of crushing (nonspecific) (906. CMC joint denervation is a relatively novel method for managing the pain associated with CMC arthritis by selectively transecting articular nerve branches to the CMC joint. 25% bupivacaine. College instructor undergoes base of thumb (CMC joint) denervation to eliminate arthritic pain with minimal down time or discomfort. Terminal branches. 1 Carpometacarpal arthritis has a predilection for older women, and this progressive disease can be debilitating and can worsen patients’ quality of life. Messages 167 Location Conway, SC Best answers 0. hansur. Before undergoing surgical CMC denervation, patients received a joint block at the first CMC joint with 0. I am the surgical coder for a group of hand surgeons - when coding 25825 the CPT clearly states with autograft (includes obtaining graft). 052. hansur. It is part of the wrist "The carpometacarpal (CMC) joints are five joints in the wrist that articulate the distal row of carpal bones and the proximal bases of the five metacarpal bones". Coding Index: CPT Hand Codes: ICD Hand Codes: AMA:. 04 closed or 833. With the introduction of novel methods, new technologies and amended trial designs, it is now rising like a phoenix out of the ashes. Pison C, Shah PL, Slebos D-J, et al. and Riley N. 53 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. It is part of the wrist "The carpometacarpal (CMC) joints are five joints in the wrist that articulate the distal row of carpal bones and the proximal bases of the five metacarpal bones". H J Klein , 10. Although orthopedists may refer to the surgery differently 25447 ( Arthroplasty interposition intercarpal or. Post-operative VAS decreased to an average of 3. 2019. 2017. Quick reference tables. Carpometacarpal (CMC) arthroplasty surgery, although modifications have occurred over time, continues to be commonly performed and has provided patients with their desired pain relief and return of function. Lancet 2020; 395:1444–51. Code Description. Use the appropriate CPT code in Item 24D on the CMS-1500 form (or electronic equivalent) and link it to the applicable ICD-9-CM code in Item 24E (or electronic equivalent). 2017. Wrist Denervation. old 115Kg 1m74, Diabetes Architect Bilateral. CPT Code Description : 25280 : Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon . 99: Rheumatoid arthritis: M12. Branches arising from the lateral antebrachial cutaneous nerve, palmar cutaneous branch of the median nerve, and radial. The HCPCS/CPT code(s) may be subject to Correct Coding Initiative (CCI) edits. Average follow-up of patients was 26. Fenig performs to treat this pain. 1 “primary arthrosis of first carpometacarpal joint, unilateral “ M25. jss. Coding Table 3 lists ICD-10-CM. 001. 2. 03. Undoubtedly, denervation of the first carpometacarpal (CMC-1) joint does represent a promising surgical treatment alternative for patients suffering from persistent CMC-1-joint osteoarthritis. The selective denervation for thumb CMC arthritis was effective in pain relief and functional recovery with several advantages, including less invasive procedure, quick recovery time, and regaining of strength. Both procedures demonstrated durable improvement in bMHQ compared with the preoperative state with similar long-term outcomes over 2 years of. 1,2 The mechanism usually occurs during hyperextension from high-velocity blunt trauma, mainly punching or falling. The same would apply if ultrasound guided. 25444 . I am having trouble finding what code would be most appropriate. 02) Metacarpal shaft fracture,. Use the following codes for facet joint denervation: 64633 Destruction by neurolytic agent, paravertebral facet joint nerve (s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint. In all studies, joint denervation improved pain and hand function at follow-up (M = 36. 01. 7 to 0. We do this by removing a small wrist (carpal) bone called the trapezium, and the bone spurs. 007. Search by CPT. 9% Coronary PCI Drug Eluting Stents (including FFR/OCT) DES, with. 1. However, the innervation pattern of the thumb CMC joint is controversial. One year after laser denervation, 17 (81 %) of 21 patients experienced complete or greater than 70 % pain reduction. 1,2 Although debated, the cause of this condition is generally thought to be mechanical wear. Carpometacarpal CMCjoints American Academy of Professional Coders – – TMC (Thumb) Session 1A, 10-11:30 AM Friday, October 26th, 2012 Hand Dissection Skin Palmar Fascia Subcutaneous tissues Bursa Pulleys/Sheaths Neurovascular bundles American Academy of Professional Coders Session 1A, 10-11:30 AM Friday, October 26th, 2012 Surgical denervation of the thumb carpometacarpal (CMC) joint is a theoretical surgical option for thumb CMC arthritis. Late effect, arm fracture (nonspecific) (905. non-operative or surgical) during their lifetime. 4 million people in the UK have osteoarthritis of the hand, requiring two million primary care consultations per annum. 0. Results Preoperative average Quick Dash was 47. Documentation, Utilization and ICD-10-CM coding sections have been added. 2017 Jun;36(3):192-197. Complete wrist denervation through a dorsal approach including neurectomy of the posterior. 11) Metacarpal base fracture, open (815. Answer: The carpometacarpal joint is considered a small joint, therefore, it is appropriate to report code 20600, Athrocentesis, aspiration, and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance, for this procedure. 01) Metacarpal base fracture, closed (815. Neurectomy of the dorsal ulnar sensory nerve articular branches. 64905 states a first stage nerve transfer, however we are not doing staged work, we are doing a permanent transfer. 1. A total of 100 patients with carpo-metacarpal (CMC) arthritis will be enrolled in the study. Look @ 833. Age-group and sex analyses are reported as numberFBN. Innervation of thumb carpometacarpal joint: implications for diagnostic block and denervation proceduresJoint denervation, a technique yielding good reproducible results in wrist and first carpometacarpal joint osteoarthritis, is, at the proximal interphalangeal joint level, a good alternative to implant arthroplasty or arthrodesis. 031 Primary osteoarthritis, right wrist. This study compares functional outcomes and pain after denervation or trapeziectomy and ligament reconstruction with tendon interposition (T+LRTI) over a 2-year period. The posterior interosseous has its roots in the cervical spine (C6, C7, C8) and arises as a branch from the radial nerve. It can be hypothesized that part or all of the pain relief. 0. 03) to postoperatively (M = 1. 6) Late effect of sprain/strain (nonspecific) (905. 2022. 11) Metacarpal base fracture, open (815. 0 cm (12045) Layer closure of wounds of neck, hands, feet and/or external genitalia; 20. More advanced disease, however, tends to require. Undoubtedly, denervation of the first carpometacarpal (CMC-1) joint represents a promising treatment alternative for patients suffering from CMC-1-joint osteoarthritis, resistant to conservative. 6. 5 months in the arthroplasty group). Local Coverage Determinations. 9% Renal denervation, bilateral 5192 0339T $4,679 $4,953 5. All VT episodes occurred in the first 4 months after ablation (2. Authors. 001) reduction in pain scores from baseline (M = 6. 1 Carpometacarpal arthritis has a predilection for older women, and this progressive disease can be debilitating and can worsen patients’ quality of life. 7) Arthrotomy, distal radioulnar joint for repair of triangular cartilage complex (25107)Denervation of the wrist joint for the management of chronic pain. on denervation in thumb carpometacarpal joint osteoarthritis. 04. 7-fold increase in the incidence of denervation since 2010 compared to a 2. Arthrotomy / synovectomy CPT Codes. Hi, CPT has several codes (64732-64772) relating to the excision or transection of the nerves. 4 to 6 weeks: Physical therapy begins. #3. Treatment with denervation may offer a quicker return to. 84). The Coding Information section has been revised to add a guideline for CPT code 72275. 1016/j. The procedure is well tolerated, with faster recovery as compared with trapeziectomy. e8. The traditionally more extensive wrist denervation has evolved to procedures requiring fewer incisions. Pooled analysis of 3 studies on the first carpometacarpal joint showed a statistically significant (P < . 25443 . Based on the documentation/abstract (below) he had gone in intending to do a LRTI procedure. Finger wounds Codes. 2 to 4 weeks: The cast and stitches are removed, and you'll be given a plastic splint to stabilize the wrist. Typically, patients have pain in the base of the thumb and with the progression of the disease: atrophy of thenar muscles, subluxation of the first carpometacarpal joint, loss of pinch and grip. on denervation in thumb carpometacarpal joint osteoarthritis 1. 4) Removal of implant; superficial, eg, buried wire, pin or rod) separate procedure removal hardware (20670) Removal of implant; deep, eg, buried wire, pin, screw, metal band, nail, rod or plate) removal of hardware (20680) Implant removal, elbow joint (24160)This is "Surgical Denervation of the Thumb Carpometacarpal Joint" by ASSH on Vimeo, the home for high quality videos and the people who love them. Examination findings may include tenderness tocompression and limited range of motion. Best answers. " See CPT Assistant February 2015/Volume 25 Issue 2. 43) Crushing injury, wrist (927. Capsulorrhaphy or reconstruction, wrist, any method eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulectomy, and open reduction) for carpal instability (25320) Reconstruction of unstable distal. Injections for other tendon origin/insertions. Most men are able to return to their usual activities within 1 to 3 days after the procedure. 6 cm to 20. 001) reduction in pain scores from baseline (M = 6. Lipoaspirate is rich in ASCs and is evolving into a promising, less-invasive tool to treat thumb carpometacarpal osteoarthritis as compared with common surgical techniques, for example, trapeziectomy or prosthesis implantation. CMC OA affects 66% of women older than 55 years 1 and an estimated 22% of the general population aged 50 years and over are symptomatic 2. from publication: Volar denervation and osteophyte resection to relieve volar CMC joint pain | At mean 125. The denervation of the first CMC joint has gained traction as a viable treatment for CMC arthritis. 28 (P<0. At mean 125. Z Disclaimer Please note this question was answered in 2019. Previous work from our group examined the use of selective denervation of the thumb CMC as a safe, effective, and novel option for patients with CMC osteoarthritis. Denervation of the thumb CMC joint has emerged as a viable treatment option. This study reviewed literature on CMC denervation for first CMC arthritis. 21) Late effect of sprain/strain (nonspecific) (905. The procedure addresses the “supply” of pain to the brain, dissecting and removing the nerve branches of the joint rather than altering the joint itself. Type in text to find: Deep Debridement CPT Codes. . Can you bill out 25210 more than once, example doctor excised the trapezium, scaphoid, & lunate. You may report only a single unit of either 64646 or 64647, per session. 81) Late effect of dislocation (nonspecific) (905. The posterior interosseous nerve travels along the posterior aspect of the forearm between the ulna and the radius. Carpal bone dislocations: an analysis of twenty cases with relative emphasis on the role of crushing mechanisms. Skin and subcutaneous tissue were elevated from the. The splint is only removed when washing or doing post-operative wrist exercises. Some authors have described the nerve branches of thumb CMC joint. With the. , and the National Emphysema Treatment Trial Research Group. My surgeons are starting to perform AIN to Ulnar nerve transfer more often and we are trying to determine the most appropriate coding. 26820. We present the innervation of the thumb CMC joint (thenar - recurrent - branch of median nerve, palmar branch of median nerve, superficial branch of. Undoubtedly,. 1097/00130911-200303000-00006. Osteoarthritis of the carpometacarpal (CMC)-1 joint is a common condition that can cause significant pain and functional problems. It can be of particular benefit in. Carpometacarpal joint denervation is a relatively novel method for managing CMC arthritis, treating the most impactful symptom: pain. 7) Late effect, arm fracture (nonspecific) (905. Nine studies were identified with 184 denervation procedures undertaken in 175 patients. CMC Denervation. It is. To appropriately report any of these modalities, use 64999). g. 53 became effective on October 1, 2023. 6 cm to 20. CPT ‡ Code 2019 Payment3 2020 Payment1 % Change 2019 Payment4 2020 Payment2 % Change Hypertension Renal Denervation Renal denervation, unilateral 5192 0338T $4,679 $4,953 5. Messages 2 Location Haverhill, MA Best. 3 The avascular. Carpometacarpal joint arthroplasty is a surgical procedure in which the trapezium, one of the carpal bones of the wrist that forms part of the thumb joint, is removed and replaced with an implant. and/or intercarpal and/or carpometacarpal joints) 21. doi: 10. #2. Methods In this paper, we present a 4- to 6-year follow-up case series on patients who underwent CMC denervation between 2015 and 2017. Suture was then passed thru the hole in base of 2nd metacarpal. Documentation, Utilization and ICD-10-CM coding sections have been added. 51 cm and 3. CPT code 77003 has been removed from the policy due to the 2017 Annual CPT code update which changed the code descriptor. Neurectomy of the anterior interosseus nerve. It is concluded that volar CMC joint denervation is a useful procedure, preserving joint function and relieving pain long-term. PROCEDURE: An incision was made over the radial edge of the flexor pronator mass just distal to the elbow flexion crease. Palmar cutaneous branch of median nerve. 05). John Flint specializes in surgical and nonsurgical treatment options for the hand, elbow and shoulder. Innervation of the dorsal aspect of the wrist joint. 61 ± 2. Non-thermal facet joint denervation (including chemical, low grade thermal energy [<80 degrees Celsius] or any other form of pulsed radiofrequency) should not be reported with CPT codes 64633, 64634, 64635 or 64636. " See CPT Assistant February 2015/Volume 25 Issue 2. He billed 64626-RT x 1 and 64627-RT, 64627-RT, 64627-RT, 64627-RT, 64627-RT. Coverage is determined by the enrollee specific benefit document andWhen the respondents did not select CPT code 25607, they instead selected codes 25280, 25290, or 76000, or selected “other” codes as the primary code. Fusion in opposition, thumb, with autogenous graft (includes obtaining graft) (26820) Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation (26841) Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft) (26842) All patients who underwent first CMC joint denervation surgery from January 2015 through September 2017 were retrospectively identified. Should I be coding under the 64600-64681 or using the unlisted code 64999. 6 ± 1. PMCID: PMC2527221. Code 64647 describes chemodenervation of six or more muscles of the trunk. 04) M18. Surgical Procedures on the Hand and Fingers. Layer closure of wounds of neck, hands, feet and/or external genitalia; 7. 3. Denervation of the thumb CMC joint has emerged as a viable treatment option. 26 $767 26842 Arthrodesis, carpometacarpal joint, thumb, with or without internalThe American Medical Association’s CPT Editorial Panel decided in June 2005 that the unlisted CPT code 64999 should be used for pulsed RF treatment as opposed to other specific codes. 1 out of 10. Neurectomy of the dorsal radial sensory nerve articular branches. Methods A systematic. October 1, 2015 *, a sample listing of the ICD-10 CM and/or ICD-10. 7 Disturbances of salivary secretion R68. Treatment with denervation may offer a quicker return to. 1 cm to 30. There was 3. 2003 Mar;7 (1):26-31. 29845 . Note: Report CPT code 64999 when facet cyst aspiration/rupture. 1 (0. Prospective Clinical Trial Comparing Trapezial Denervation With Trapeziectomy for the Surgical Treatment of Arthritis at the Base of the Thumb J Surg Res. 007. The qualified healthcare providers injects a diagnostic or therapeutic agent into a facet joints to treat the spinal pain or to identify the exact source of pain with using of imaging guidance of either fluoroscopy or CT scan. Patient with right thumb metacarpophalangeal (MCP) joint instability, carpometacarpal (CMC) osteoarthritis, and wrist scaphotrapeziotrapezoidal (STT) arthritis presents for treatment of the thumb and wrist. Purchase a subscription I’m already a subscriber. We read with great interest the recent systematic review by Teo I. My physician performed an. Results Carpometacarpal CMCjoints American Academy of Professional Coders – – TMC (Thumb) Session 1A, 10-11:30 AM Friday, October 26th, 2012 Hand Dissection Skin Palmar Fascia Subcutaneous tissues Bursa Pulleys/Sheaths Neurovascular bundles American Academy of Professional Coders Session 1A, 10-11:30 AM Friday, October 26th, 2012 Pain in joint, forearm (719. As far as I understand these should be coded using CPT Code 64772. First carpometacarpal joint denervation: anatomy and surgical technique. Long-term follow-up. 26230. The corresponding medical conditions for which Botulinum toxins are used should be listed with the respective CPT code. Intradiscal biacuplasty (IDB) (Baylis Medical Inc. One non-randomised clinical trial reported no difference in outcome when comparing denervation of the first carpometacarpal (CMC I) joint to trapeziectomy. and Riley N. Pain relief is variable and gradual over 18 months. 20612 Aspiration and/or injection of ganglion cyst(s) any location 20615 Aspiration and injection for treatment of. Late effect of hardware or graft (996. Jan 27, 2020. 69 ± 1. Using fiberwire suture, a suture was placed at both ends. 0. Between 2006 and 2018, 46 patients underwent the procedure in our clinic and were included in this retrospective study. 10, 11, 12 Anatomic studies have shown that sensory innervation of the CMC joint is derived from branches of the lateral antebrachial cutaneous nerve, palmar cutaneous branch of the median nerve, and radial sensory. old 115Kg 1m74, Diabetes Architect Bilateral Painful CMC OA No MCP joint hyperextension LEFT SIDE Preoperative Work Up Follow Up -2016 Immediate Post Op –2012 MALE 61 Y. 7-fold increase in the incidence of denervation since 2010 compared to a 2. Thumb carpometacarpal joint (CMCJ) osteoarthritis (OA) is a common problem affecting 7% of men and 15% of women. 7 Disturbances of salivary secretion This article was converted to the new Billing and Coding Article type. Exploration of penetrating extremity wound separate procedure (20103) Superficial Debridement. Layer closure of wounds of neck, hands, feet and/or external genitalia; 7. BOSTON — In this video from the American Society for Surgery of the Hand Annual Meeting, Joshua Hustedt, MD, said patients with carpometacarpal arthritis recover faster from carpometacarpal. Contracture Release Codes. 02) Metacarpal shaft fracture, closed (815. 1007/s11552-007-9068-9. 2). Selective Thumb Carpometacarpal Joint Denervation for Painful Arthritis: Clinical Outcomes and Cadaveric Study J Hand Surg Am . When a patient experiences pain thatis not relieved by conservative therapies, a corticosteroid injectionis indicated. High complexity – 40 minutes: 99215. Thumb carpometacarpal osteoarthritis (CMCJ OA) is a common problem. Arthroplasty with prosthetic replacement, trapezium (25445) Interposition arthroplasty, intercarpal or carpometacarpal joints (25447) Partial Trapezoid excision. Excision of epiphyseal bar, with or without autogenous soft tissue graft obtained through the same fascial incision (20150) Excision or curettage of bone cyst or benign tumor; humerus; with autograft includes graft harvest (24115) Excision or curettage of bone cyst or benign tumor; humerus; with allograft (24116) Excision. 12) Carpometacarpal dislocation, closed (833. 6, and 55. If denervation is performed bilaterally, Modifier 50 should be appended to the procedure code with number of services of one. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code M62. 030. Surgical denervation of the thumb carpometacarpal (CMC) joint is a theoretical surgical option for thumb CMC arthritis. Note: Report CPT code 64999 when facet cyst aspiration/rupture. #1. 04 _) is rare by comparison, though it. Selective denervation of the CMC joint is an effective approach to treat pain and alleviate impairment associated with CMC arthritis. 2 The most commonly involved joints are the fourth and fifth CMC joints. This procedure is performed when all other treatment options. CMC OA affects 66% of women older than 55 years 1 and an estimated 22% of the general population aged 50 years and over are symptomatic 2. doi: 10. The Coding Information section has been revised to add a guideline for CPT code 72275. 1 Denervation of first CMC joint. Hypertension 2012; 60(2):419-24. 11) Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia (26700) Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring. I agree with 20600 for the CMC injection code. Papatheodorou et al. For the study cohort, the conversion rate to T + LRTI at 2 years was 9%. J Am Acad Orthop Surg. 0. 1016/j.