CommercialBilling CodesHigh impact
Surgery of the Wrist or Thumb
UnitedHealthcare·Orthopedics, General Surgery, Plastic Surgery·Medical Policy
Effective date
Aug 1, 2026
We identified it
Jul 2, 2026
Summary
This policy narrows coverage scope from 'Surgery of the Hand or Wrist' to 'Surgery of the Wrist or Thumb,' removing coverage for finger joint procedures (MCP and PIP arthroplasty, diagnostic wrist arthroscopy, and wrist arthroplasty revision). Six CPT codes are deleted from the applicable codes list, and documentation requirements now mandate inclusion of treatment duration in addition to dates and reasons for prior therapy discontinuation.
Action Required
By August 1, 2026: Billing team must remove CPT codes 25449, 26530, 26531, 26535, 26536, and 29840 from the approved billing code list in the billing system and deny or route for manual review any claims submitted with these codes for wrist or thumb procedures under this commercial policy. Providers must update documentation templates to capture prior therapy duration in addition to dates and discontinuation reasons. Update clinical staff to clarify that finger joint surgeries (MCP/PIP arthroplasty and diagnostic wrist arthroscopy revision procedures) are no longer covered under this policy effective August 1, 2026. Claims submitted after the effective date with deleted codes will be denied.