0LM74ZZ
Reattachment Hand Tendon, Right to No Qualifier with No Device, Percutaneous Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | L Tendons |
| Operation | M Reattachment |
| Body Part | 7 Hand Tendon, Right |
| Approach | 4 Percutaneous Endoscopic |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Putting back in or on all or a portion of a separated body part to its normal location or other suitable location
Procedure Overview
Reattachment procedures on tendons address situations where a tendon has been completely severed or avulsed from its normal attachment point and needs to be surgically reconnected. This happens after traumatic injuries such as lacerations from sharp objects, sports injuries that tear a tendon from bone, or amputation and replantation cases where an entire digit or limb segment, along with its tendons, must be rejoined.
The goal is to restore continuity so the muscle-tendon unit can once again transmit force to move a joint, whether that's a finger flexor tendon cut in a workshop accident or an Achilles tendon torn from the calcaneus. Surgeons typically suture the tendon ends together or anchor the tendon back to bone using sutures or fixation devices, then protect the repair with splinting or bracing during healing.
Because tendons have limited blood supply, timing and technique matter, and reattachment is often performed urgently to give the best chance of the tissue healing back together and regaining strength.
Anatomy & Axis Detail
Hand Tendon, Right
Hand tendons on the right include the intrinsic and extrinsic flexor and extensor tendons that move the fingers and thumb, structures frequently injured by lacerations, crush trauma, or sharp objects. Reattachment is used when a tendon has torn free from its distal insertion, commonly at the terminal extensor tendon in mallet finger deformity or a flexor digitorum profundus avulsion pulled from the distal phalanx, sometimes called a jersey finger. Because hand tendons operate through pulleys and narrow sheaths, the surgeon must restore correct tension and gliding alignment when fixing the tendon back to bone, often with a suture anchor or pull-through technique. Given how many discrete tendons pass through the hand, precise identification of the injured structure is essential for accurate right-hand documentation.
Approach: Percutaneous Endoscopic
Percutaneous Endoscopic combines a puncture through skin or mucous membrane with insertion of an endoscope to visualize the procedure internally, as in laparoscopic cholecystectomy. It is distinguished from plain Percutaneous by the presence of scope-guided visualization, and from Via Natural or Artificial Opening Endoscopic by its route being a new puncture rather than an existing orifice or stoma.
Coding & Documentation
A Reattachment code applies when the documentation clearly states that a tendon was completely separated from its body and is being put back to its normal or a suitable anatomic location. The operative note should specify which tendon was involved, whether the reattachment is to its original site or an adjacent structure, and the approach used, since fine and gross motor tendons in the hand and foot have many separately identified body part values.
The recurring assignment error is coding Reattachment for injuries that are only partial tears, which belong under Repair instead, since Reattachment requires complete detachment. Another common mistake is confusing tendon reattachment during a replantation with the reattachment codes for the limb or digit itself; both may need to be coded separately when multiple structures are reconnected in one procedure. Coders also sometimes miss that reattaching a tendon to a different location than its original one, such as during certain reconstructive transfers, may actually point to Transfer rather than Reattachment.