Purchase a subscription I’m already a subscriber. Hi, CPT has several codes (64732-64772) relating to the excision or transection of the nerves. Objective. Objective. Results: Denervation was safe, with less downtime than trapeziectomy with ligament reconstruction with tendon interposition and provided durable complete or partial relief of pain after 5 years in 5 of 9. Pain scores for AKP were significantly better in the denervation group at 3 months but not at 12 and 24 months. }, author={Raymond Rath and Max Haerle. and Riley N. The CMC Ligament Reconstruction Kit provides a convenient all-in-one solution for ligament reconstruction of the base of the thumb. 3)Adipose-derived mesenchymal stem cell (ASC) therapy is currently a focus of regenerative medicine. Hardware CPT Codes. 1 (0. 03) to postoperatively (M = 1. In an Ambulatory Surgical. ICD-10 Codes Description K11. non-operative or surgical) during their lifetime. Denervation surgery is an innovative approach to treating painful joints. Location. Since the resulting chemical denervation of muscle produces local paresis or paralysis, selected muscles can be treated. 26670 - CPT® Code in category: Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint CPT Code information is available to subscribers and includes the CPT code number, short description, long description, guidelines and more. 00 - M08. (2012) Sympathetic innervation of the anterior left ventricular wall by the right and left stellate ganglia. Denervation of the proximal interphalangeal joint: a realistic and simple procedure. Low complexity – 15 minutes: 99213. Best answers. Prospective. Resection of the trapezium, often combined with soft tissue stabilization, is still considered the gold standard. It is concluded that volar CMC joint denervation is a useful procedure, preserving joint function and relieving pain long-term. Patient satisfaction was higher in the denervation group. 26230. 01) Metacarpal base fracture, closed (815. 21) Late effect of sprain/strain (nonspecific) (905. C. 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. Arthritis of the First Metacarpophalangeal Joint (M19. Denervation of the thumb CMC joint has emerged as a viable treatment option to manage pain related to OA. 04) Need help with CPT and modifiers for the following scenario: Denervation of branches using transection from: 1. American. 10. 04)M18. NCT03558204. Foucher was convinced that. Metacarpophalangeal dislocation, closed (834. wneu. Nine studies were identified with 184 denervation procedures undertaken in 175 patients. To appropriately report any of these modalities, use 64999). 6 months, pain was reduced from mean of 8. 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". Complete wrist denervation through a dorsal approach including neurectomy of the posterior. [1]Abductor pollicis brevis is the most lateral and the most superficial of thenar muscles, located underneath the skin. I am hesitant, would this approach my provider is describing qualify as MIS as he states his approach is. 1,2 The mechanism usually occurs during hyperextension from high-velocity blunt trauma, mainly punching or falling. The purpose of this study is to analyse the evidence for thumb CMCJ denervation; evaluating patient selection, surgical techniques, complications and outcomes. In the United States, up to 8% of men and 25% of women with ages 50 years and older suffer from degenerative arthritis of the thumb carpometacarpal (CMC) joint, 1 with about 20% of affected people requiring some form of treatment (i. Coding Table 3 lists ICD-10-CM. Optum states "Code 25825 (column 1) has a CCI conflict with code 25210. Neurectomy of the anterior interosseus nerve. The clinical outcomes were more effective in the early-stage group (Eaton stages I and II. American Society for Surgery of the Hand assh. CMC joint thumb, with or without internal fixation; with or without autograft) and CPT code 26820 (fusion in opposition, thumb, with autogenous graft). There was no statistically significant change in the average grip. The traditionally more extensive wrist denervation has evolved to procedures requiring fewer incisions. jhsa. Suture was tied over the bridge between the 2 smaller holes. He billed 64626-RT x 1 and 64627-RT, 64627-RT, 64627-RT, 64627-RT, 64627-RT. A CMC arthroplasty was performed along with excision of the trapezoid bone. Neurectomy of the dorsal radial sensory nerve articular branches. 11) Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia (26700) Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring. 2. All patients demonstrated improved grip strength at diagnostic injection. 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. 1016/j. Page 443 CPT AMA 2020 edition - definition of neuroplasty is spelled out so it's no wonder they won't pay the 24359 no matter what modifier you slap on it. We investigated the effect of an extended denervation procedure in the thumb carpometacarpal (CMC) joint in patients suffering from CMC osteoarthritis. Best answers. Dr. 03) to postoperatively (M = 1. Arthroscopy. Best answers. Enrollment will occur at the time. Thumb carpometacarpal osteoarthritis (CMCJ OA) is a common problem. Tech Hand Up Extrem Surg. #5. 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. CPT® code 64611; HCPCS codes J0587, J0585, J0588 Group 3 Codes: (2 Codes) CODE DESCRIPTION K11. The Tenodesis Screw with a convenient disposables kit the CMC Ligament Reconstruction Kit will enable a faster, more convenient repair providing strong and immediate fixation of the tendon graft. 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. 08/01/2019 R4 The title of the article has been revised to add Billing and Coding. Only patients with a good response to injection were selected for surgical denervation. DOI: 10. Common Topics: Amputations; Arthritis; Arthroplasty; Aspirate / Inject; Basal Joint; Burns; CTS / Pronator; Collagen Vasc; Congenital; Contractures; Contusion. 40 TABLE 3. Best answers. 1. Lancet 2020; 395:1444–51. Multiple carpometacarpal dislocations. 3-2 ). reported less promising results, with only 32% patient satisfaction in their series of 36 joints [22]. 11. Overall, in 4 patients (19 %), the response to laser denervation at 1-year follow-ups was not successful. Page 5 of 18 . Bilateral Painful CMC OA No MCP joint hyperextension LEFT SIDE Preoperative Work Up Immediate Post Op –2012 MALE 61 Y. Complete wrist denervation through a dorsal approach including neurectomy of the posterior. Botulinum toxins are used in the treatment of overactive skeletal muscles, smooth muscles, and glands. Results. When nonoperative management fails, surgery may be indicated. Injury & Clinical Conditions. @article{Rath2022DenervationOT, title={Denervation of the thumb carpometacarpal joint for symptomatic osteoarthritis in 46 patients. Medial calcaneal sensory. Denervation of the thumb CMC joint has emerged as a viable treatment option. Average follow-up of patients was 26. Case 2 (urodynamic): 51729, 51741, 51784, 51797, 52000. 3. The main function of abductor pollicis brevis is the abduction of the thumb at the carpometacarpal joint. Only patients with a good response to injection were selected for surgical denervation. , wrist denervation substantially reduces pain in radiocarpal osteoarthritis [6–10]. 26 $767 26842 Arthrodesis, carpometacarpal joint, thumb, with or without internal Best answers. Fenig performs to treat this pain. 541 - M12. Any help would be greatly appreciated. 2. First carpometacarpal (CMC) joint osteoarthritis (OA) is commonly encountered in clinical practice. #2. This procedure can help manage symptoms of thumb arthritis by decreasing pain and improving use of the thumb for gripping, pinching, and grasping. A needle or 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. 1. Username Forgot my Username. 69 ± 1. Neurectomy of the dorsal ulnar sensory nerve articular branches. Purpose The first carpometacarpal (CMC) joint is a frequent location of osteoarthritis in the hand. 2 3 Some studies have reported that the efficacy of partial neurectomy in relieving chronic wrist pain is inconsistent as compared with total. 13) Malunion of fracture (733. CPT® Code Description PI 2021 Medicare National ASC Average Payment 2021 Medicare National Average Physician Payment (Facility Setting) 27130 Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft J8 $8,833 $1,322 Ambulatory Surgical Center Physician CPT® Code. Medical conditions that can affect the thenar eminence include carpal tunnel syndrome, arthritis, and amyotrophic lateral sclerosis (ALS), among others. You would not report 29874, 29877, 29881 or 29882 if these procedures are performed in the same compartment as the. Between October 2005 and August. denervation treatment option, many desired that op-tion over arthroplasty due to the perception that denervation was less invasive. Other patients may be better served with a vasectomy reversal, conversion to an open-ended vasectomy, excision of a sperm granuloma, or epididymectomy. Solutions . 2017 Jun;36(3):192-197. 17. Denervation of the thumb CMC joint has emerged as a viable treatment option. Arthroplasty with prosthetic replacement; distal radius :AHA Coding Clinic ® for HCPCS - 2017 Issue 2; Ask the Editor Carpometacarpal arthroplasty. 13) Malunion of fracture (733. Renal Hemodynamics and Renal Function After Catheter-Based Renal Sympathetic Denervation in Patients With Resistant Hypertension. My surgeons are starting to perform AIN to Ulnar nerve transfer more often and we are trying to determine the most appropriate coding. 9% $2,003 $2,142 6. This article was converted to the new Billing and Coding Article type. Finger wounds Codes. It can be of particular benefit in. 0 branch at the fifth carpometacarpal (CMC) joint (range, 0–2; Table 1). 1016/j. Hand osteoarthritis—a heterogeneous disorder. For the procedure, our surgeon will make several small incisions in the affected area to meticulously and. 67, p < . PHYSICAL THERAPY. It is a sensory nerve. 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. 16. 11) Metacarpal base fracture, open (815. 2018. Lower extremity sensory and mixed nerves A. 01. We investigated the effect of an extended denervation procedure in the thumb carpometacarpal (CMC) joint in patients suffering from CMC osteoarthritis. 30465956. LAPAROSCOPIC LIVER BIOPSY CPT code(s) to report Descriptor Global period Work RVU Total RVU 47562 Laparoscopy, surgical;. The same would apply if ultrasound guided. 6 cm to 20. Code 25442. Jan 25, 2017. PMID: 18780059. 0 cm (12045) Layer closure of wounds of neck, hands, feet and/or external genitalia; 20. Chemodenervation is the blockade of neuronal signaling at the neuromuscular junction using botulinum neurotoxin (BoNT). 008 Corpus ID: 253927867; Denervation of the thumb carpometacarpal joint for symptomatic osteoarthritis in 46 patients. PMID: 29934083 DOI: 10. When a patient experiences pain thatis not relieved by conservative therapies, a corticosteroid injectionis indicated. J Hand Surg. The posterior interosseous has its roots in the cervical spine (C6, C7, C8) and arises as a branch from the radial nerve. A Prospective Clinical Trial Comparing Denervation With Suspension Arthroplasty for Treatment of Carpometacarpal Arthritis of the Thumb. 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. 12 Recent attention has been placed on the role of CMC denervation in the treatment of CMC arthritis. 0 cm (12045) Layer closure of wounds of neck, hands, feet and/or external genitalia; 20. 2018. H J Klein , 10. Occipital Nerve (CPT Code 64744) for Treatment of Headaches . 1,2 Although debated, the cause of this condition is generally thought to be mechanical wear. 5 months post-op (range of 12-57 months) Average number of therapy sessions 16. When nonoperative management fails, surgery may be indicated. ”. Although orthopedists may refer to the surgery differently 25447 ( Arthroplasty interposition intercarpal or carpometacarpal. doi: 10. 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. dr. CPT code 64625 has been added to CPT/HCPC Codes Group 2 effective for dates of service on or after 01/01/2020. The new evidence has come in recent years, assuring the antihypertensive effect of RDN. 5 cm (12044) Layer closure of wounds of neck, hands, feet and/or external genitalia; 12. 69 ± 1. 4 to 6 weeks: Physical therapy begins. Prospective Clinical Trial Comparing Trapezial Denervation With Trapeziectomy for the Surgical Treatment of Arthritis at the Base of the Thumb J Surg Res. 1 cm to 30. Joint denervation presents a number of theoretical advantages over more traditional surgical options; it is minimally invasive, it does not require a prosthesis or postoperative immobilisation, and does not preclude future surgery. 1016/j. 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. Osteoarthritis of the carpometacarpal (CMC)-1 joint is a common condition that can cause significant pain and functional problems. doi: 10. These services should be reported with CPT code 64999. Palmar cutaneous branch of median nerve. Fluoroscopic guidance and localization. 2 The dorsal part of the SLL is the strongest and the primary stabiliser of the SL joint and can resist forces of up to 260 N. The meaning of DENERVATE is to deprive of a nerve supply. Power your marketing strategy with perfectly branded videos to drive better ROI. Coding and Payment Guide for Medicare Reimbursement: The following are the 2018 Medicare coding and national payment rates for Radio Frequency Ablation (Peripheral Nerves) procedures performed in an ambulatory surgical center, physician office, or outpatient hospital. 3 ± 0. There were no articular branches to the ulnocarpal joint in one specimen (6%) and to the fifth CMC joint in two specimens (12%). Google Scholar Kloppenburg M, Kwok WY. [ Read More ] Laparoscopic. 1. 26841. The same would apply if ultrasound guided. 1016/j. 25447: interposition arthroplasty, intercarpal, or carpometacarpal joints; 26480: tendon transfer or transplant, carpometacarpal area or dorsum of hand, single, without free graft, each. I agree with 20600 for the CMC injection code. There was 3. 64718 includes transposition but does it include fully anastomosing the two. interosseous nerve. 90 cm from the Listers tubercle. Abstract and Figures. I have a provider that is doing a Radiofrequency Ablation right Cervical Facet Joint medical branch nerves; C2, C3, C4, C5, C6, and 3rd occipital nerve. However, using Cozzi’s technique, Foucher et al. Hope this helps. For requests for non-pulsed radiofrequency denervation of cervical facet joints (C2-3 and below), thoracic facet joints, or lumbar facet joints, please provide the following current clinical notes:Denervation patients had a reduced time to return to function (3. Arthrotomy / synovectomy CPT Codes. 030. 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. 00 57250 Posterior repair, rectocele N/A $614 N/A 17. Injections for plantar fasciitis are addressed by 20550 and ICD-10-CM M72. He mentioned only the superficial branch of the radial nerve (SBRN) to supply the thumb CMC joint and reported 87% good results in 170 patients. Surgical Procedures on the Hand and Fingers. 2 (5. The VAS pain score decreased from an average of 7. Thumb carpometacarpal (CMC) joint denervation is a relatively novel method for the management of osteoarthritis-associated pain by selective transection of articular nerve branches of the CMC joint. [ 59] described three components of the revision procedure for failed thumb CMC arthroplasty: (1) preserving the space flanked by the metacarpal and scaphoid, (2) identifying and addressing any underlying scaphotrapezoid joint arthritis, and (3) treating MCP hyperextension. ”. Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans. 007. Keywords: Denervation, CMC, joint. CMC Arthrodesis. 01) Metacarpophalangeal dislocation, open (834. 99. hansur. Superficial radial nerve. Multiple carpometacarpal dislocations. 7) Late effect, arm fracture (nonspecific) (905. Conclusions: Selective denervation of the CMC joint is an effective approach to treat pain and alleviate impairment associated with CMC arthritis. Conclusions: Carpometacarpal denervation appears to provide similar short-term outcomes as suspension arthroplasty for the treatment of thumb carpometacarpal arthritis. 8 months, range = 3-90 months). Background: Joint denervation of the wrist, basal joint of the thumb, and the finger is an option for patients with chronic pain. Fluoroscopic and CT guidance and. Host virtual events and webinars to increase engagement and generate. Should I be coding under the 64600-64681 or using the unlisted code 64999. Hand surgeons who document thumb carpometa-carpal stabilization" " "Eaton procedure" or "LRTI" in their notes often stump orthopedic coders who cannot locate any such descriptors in CPT. The vast array of available surgical techniques includes excisional arthroplasty, limited and total fusion, total wrist denervation, partial and total arthroplasty, as well as rib-cartilage graft implantation. This study reviewed literature on CMC denervation for first CMC arthritis. Osteoarthritis of the carpometacarpal (CMC)-1 joint is a common condition that can cause significant pain and functional problems. 5 months in the arthroplasty group). BILLING/CODING INFORMATION: The following codes may be used to describe neurolysis: NOTE: Per CPT coding guidelines, codes 64633, 64634, 64635, and 64636 exclude pulsed radiofrequency methods. Surgery. All VT episodes occurred in the first 4 months after ablation (2. Criteria. Z Disclaimer Please note this question was answered in 2019. 29845 . It is. CMC denervation with extension to the wrist was similar to the technique described by Giesen et al. 4 million people in the UK have osteoarthritis of the hand, requiring two million primary care consultations per annum. It runs from the scaphoid and trapezium carpal bones, and from the flexor retinaculum to the proximal phalanx of thumb. radiofrequency denervation: a multi-center analysis. Anatomy: The basal joint of the thumb is also known as the carpometacarpal (CMC) joint. It is a procedure used for pain relief purposes in conditions such as advanced wrist arthritis, following wrist fractures, or severe ligament injuries. 14 open for joint dislocation CMC and check your documentation to see if it was a dislocated joint and/or a carpal and/or a metacarpal bone. The Coding Information section has been revised to add a guideline for CPT code 72275. Most men are able to return to their usual activities within 1 to 3 days after the procedure. 2019 Jan;44(1):64. Phase. 04)Carpometacarpal (CMC) Joint / Trapeziometacarpal (TMC) Joint. Jan 17, 2012. 03) Thumb base metacarpal fracture, open (815. Superficial radial nerve. 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. We hypothesized that joint denervation is an effective way of treating the pain associated with first CMC arthritis. 2 A cost analysis study conducted in the. Late effect of hardware or graft (996. Patient satisfaction was higher in the denervation group. 1998;2(1):25-35. Good morning! We've had a little back and forth going on in my office regarding a patient's surgery. Lateral antebrachial cutaneous nerve. From an Orthopedic standpoint, "arthritis of the base of the thumb" most likely & commonly refers to arthritis of the First Carpometacarpal Joint of the thumb, M18. Lumbar zygapophysial (facet) joint radiofrequency denervation success as a function of pain relief during diagnostic medial branch blocks: a multicenter analysis. A review of four cases. and/or intercarpal and/or carpometacarpal joints) 21. 25% bupivacaine. New Haven, IN. The origin of the nerve root must be known to reference the proper CPT code. 6 months, pain was reduced from mean of 8. Local Coverage Determinations. 27). Diagnosis is made clinically with a painful CMC grind test and radiographs of the hand showing osteoarthritis of the 1st CMC joint. Wrist Denervation. Ankeny, IA. Renal denervation did not result in any significant long-term increase in renal artery stenosis or worsening of renal function. It is. It can be hypothesized that part or all of the pain relief. 061. The insurance company is denying the 64627 stating this is an. 16 Salibi et al16 also chose a prospectivePROCEDURE PERFORMED: Decompression median nerve, forearm. 01) Metacarpophalangeal dislocation, open (834. 8 months, range = 3-90 months). Code Description. Documentation Requirements. Search by CPT. 12) Carpometacarpal dislocation, closed (833. + 64634 each additional facet joint (List separately in addition to code for primary procedure) 64635 Destruction by neurolytic. Selective thumb carpometacarpal joint denervation for painful arthritis: clinical outcomes and cadaveric study. CPT Knowledgebase - Oct 26, 2017 When a physician performs a right first carpometacarpal joint injection without ultrasound guidance, is it appropriate to report code 20605 for an intermediate joint injection (eg, wrist), or is it appropriate to report code 20600 for a small joint injection? Login. 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. 53 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Papatheodorou et al. For every operated hand, the Kapandji score, key-pinch strength, grip strength and pain on a. Wrist arthrodesis, also known as wrist fusion, is a procedure in which the wrist joint is immobilized by fusing the radius to the carpal bones. (2014) Cardiac sympathetic denervation in patients with refractory ventricular arrhythmias or electrical storm: intermediate and long-term follow-up. 9% $2,003 $2,142 6. 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. Vanden Berge DJ, Kusnezov NA, Rubin S, et al. Aug 10, 2011. 51 cm and 3. 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". Long-term follow-up after ligament reconstruction with tendon interposition. 26235. 1 Denervation of first CMC joint. Before undergoing surgical CMC denervation, patients received a joint block at the first CMC joint with 0. 0001). We do this by removing a small wrist (carpal) bone called the trapezium, and the bone spurs. 2018. 031 Primary osteoarthritis, right wrist. Chemical neurolysis is the application of a chemical agent directly to a nerve or motor point to intentionally interfere with nerve conduction through destruction of a portion of the nerve. e8. Phase 3: Studies that gather more information about safety. Neurolysis is performed with. CPT Codes. 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. For the study cohort, the conversion rate to T + LRTI at 2 years was 9%. Results from a consecutive series of 13 patients with thumb CMC arthritis who underwent joint denervation were retrospectively reviewed. You don't have many to choose from depending on that was done or using an unlisted code 29999. Ask Dr. 2003 Mar;7 (1):26-31. Arthritis of the first carpometacarpal (CMC) joint of the hand is a common and often debilitating disease. In the middle third of the forearm, it lies behind the same muscle, close to the lateral side of the artery. 008. Aug 11, 2020 #1 Hello, I'm trying to figure out which cpt code better fits. FEP 7. Neurectomy of the dorsal ulnar sensory nerve articular branches. 4 to 6 weeks: Physical therapy begins. " See CPT Assistant February 2015/Volume 25 Issue 2. 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. These investigators reported on the outcome of patients treated with this procedure for ST in their department. American. 10 $761 CMC Joint Fusion CPT® Code Description 2020 Total RVUs 2020 Medicare National Average Payment 26841 Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; 21. Selective denervation has been successfully employed to treat arthritis pain in a number of joints throughout the body. You would have to use 55899. This pain affects the quality of life in 2. The procedure is well tolerated, with faster. hansur. A graft jacket was rolled. 11) Metacarpal base fracture, open (815. , and the National Emphysema Treatment Trial Research Group. 12) Carpometacarpal dislocation, closed (833. 6 cm to 12. 05). 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. 0 cm (12046)2. 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. Question ID : 12304. Quick reference tables. 2017.