Cpt code trigger thumb release

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Trypophobia is the fear of clustered patterns of holes. Learn more about trypophobia symptoms, causes, and treatment options. Trypophobia, the fear of clustered patterns of irregul...In this case, you may report code 26055 (Tendon sheath incision [e.g., for trigger finger]) for the trigger finger release. So, you report both the mass excision and the trigger finger release. You should append modifier 59 (Distinct procedural service…) to indicate that the procedures were done at different locations via separate incisions.a trigger finger. You released the A1 pulley and excised a slip of the FDS. Trigger finger release is typically reported using 26055 (Tendon sheath incision (e.g., for trigger finger). That’s what I used for trigger thumbs, should I use that for the trigger finger too? Should I add an additional code for the FDS slip excision?Trigger finger is more common among women than men and symptoms include popping, catching, pain and limited movement in the finger. Trigger finger occurs when tendons of the finger or thumb become inflamed. As the flexor tendon becomes irritated, it can become thicker and develop a nodule, making it difficult to move the tendon through its ...Trigger Finger Codes MOST COMMON COMBO Trigger finger (727.03) Tendon sheath incision eg, for trigger finger) (26055) Coding Submenus Mucous cyst. ICD9 Codes Synovitis, hand (719.24) Trigger finger (727.03) Ganglion of tendon sheath (727.42) Contracture of joint, hand/fingers (718.44) Loc prim osteoarthritis, hand (715.14) Pain in joint, hand ...Mar 17, 2016. #1. Ultrasound guided percutaneous trigger finger release. A coworker said that they have billed 26055, 76942 and 76881. I think only the 26055 and 76942 are correct codes. I'm not sure why a complete ultrasound would be billed with ultrasound guided needle placement. ??Typically, trigger finger release is an outpatient procedure, with an injection of local anesthesia to numb the area for surgery. It can be performed with or without sedation (medication that puts you to sleep). Surgery is usually performed through either a small open incision in the palm or with the tip of a needle. The A1 pulley is divided ...

Abstract. Stenosing tenosynovitis (aka “trigger finger”) is a common condition in adults, with “trigger thumb” commonly occurring in children. These conditions are due to impairment of the normal sliding of the digit’s flexor tendon thru the A-1 pulley (resulting from flexor tendon inflammation). This condition can be managed ...Novel CPT codes have been added with Needle insertion without injection processes (eg, dry nailing, trigger-point accupunture). CPT code 20560 and 20561 are spent for coding without injection forward muscle utilizing annoy. 20560 Needle insertion(s) less injection(s); 1 or 2 muscle(s) 20561 3 or more musclesDespite this, many clinicians have been performing percutaneous trigger thumb releases. Percutaneous release has been reported to be safe and as effective as open surgical release of the A1 pulley. 10, 11 Many complications have been reported from percutaneous trigger thumb release including insufficient release, tendon laceration, bowstringing ...Trigger thumb, left thumb. M65.312 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM M65.312 became effective on October 1, 2023. This is the American ICD-10-CM version of M65.312 - other international versions of ICD-10 M65.312 may differ.How to Identify Stress Triggers - Learning how to identify stress triggers, or stressors, is the first step in reducing your stress level. Learn how to target stress inducers in yo...Trigger Release. Trigger finger is a condition that causes pain, stiffness, and a sensation of locking or catching when you bend and straighten your finger. The condition is also known as “stenosing tenosynovitis.”. The ring finger and thumb are most often affected by trigger finger, but it can occur in the other fingers, as well.Trigger finger, right middle finger M65.332 Trigger finger, left middle finger M65.341 Trigger finger, right ring finger ... 20561 and 64625 have been added to a new CPT/HCPCS Codes section (Group 4). CPT code 64451 has been added to the CPT/HCPCS Codes section Group 3 and ICD-10 Codes that Support Medical Necessity …5 Some authors have gone further and advocated a routine stepwise reconstruction of the A1 pulley following the trigger finger release in an attempt to counteract these potential problems. 4. Progressive ulnar deviation of all fingers after separate sequential trigger finger releases in a nonrheumatoid hand was reported by Flatt (2007).

CPT Code 26123, Surgical Procedures on the Hand and Fingers, Excision Procedures on the Hand and Fingers - Codify by AAPC. Select. Code Sets ... PROCEDURE: 1. Release of left ring finger Dupuytren's contracture. 2. Release IP jo... [ Read More ] Dupuytren Fibromatosis - Palmar Fasciectomy. So the codes billed would be 26123-F4 …For the thumb, a 2-5 mm incision is created along the palmar digital crease. S2S Surgical introduces a minimally invasive Trigger Finger Release procedure. The Distal Palmar crease is used for the middle, ring and small fingers. The Proximal Palmar Crease is used for the index finger and the palmar digital crease for the thumb.Despite this, many clinicians have been performing percutaneous trigger thumb releases. Percutaneous release has been reported to be safe and as effective as …Answer: Yes, you can report codes such as 26055 ( Tendon sheath incision [e.g., for trigger finger]) multiple times during the same procedure when appropriate. List …CPT Code 26115, Surgical Procedures on the Hand and Fingers, Excision Procedures on the Hand and Fingers - Codify by AAPC ... Excision dupuytren's nodule & trigger finger release [QUOTE="ahodge90, post: 498716, member: 459465"] I have a very similar case that I am looking for some guidance on. I have a trigger middle finger and a palmar …Here is a step-by-step description of percutaneous release for trigger finger: The surgeon administers a local anesthetic, typically lidocaine. The physician uses ultrasound imaging to carefully guide the needle to the affected tendon sheath and avoid damage to the tendon or nearby nerves. Most physicians will use a 16- or 18-gauge needle ...

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Mar 25, 2014. #1. Hello. A patient had a Release of A1 pulley of the thumb. In the op note it indicates that a transverse incision was made across the flexion crease of the MCP joint of the thumb, carried down bluntly through the subcutaneous tissue down to the Ai pulley. The A1 pulley was divided with a small scissor without difficulty.In the world of medical billing and coding, CPT codes play a crucial role. These codes, also known as Current Procedural Terminology codes, are used to identify and document medica...In the world of medical billing and coding, accurate CPT code descriptions are essential for ensuring proper reimbursement and maintaining compliance. CPT codes, or Current Procedu...6. Best answers. 0. Feb 8, 2011. #4. 20550 says "injection (s) of a single tendon sheath...) the coding tips in the coding companion state that if more than one tendon is injected in the same incounter, each injection should be reported separately. You can bill 20550 more than once during the same encounter.6. Best answers. 0. Feb 8, 2011. #4. 20550 says "injection (s) of a single tendon sheath...) the coding tips in the coding companion state that if more than one tendon is injected in the same incounter, each injection should be reported separately. You can bill 20550 more than once during the same encounter.

Benefits include: 16-18. Performed in your office or procedure room. Can be performed using local anesthesia. Faster return to normal activities versus traditional …Apr 2, 2006 · Therefore, if your surgeon performs trigger finger releases on the thumb and second finger of the right hand, you should report 26055-F5 and 26055-F6. If your insurer does not accept the finger modifiers, you should revert to modifier 59 for the second line item of 26055. The spontaneous recovery rate for locked pediatric trigger thumb (PTT) has recently been reported at between 24% and 66%; these studies concluded that a conservative approach for this condition ...Intrinsic release of the index middle ring and small finger/opponens pollicis release hand coding hand specialist hand surgery intrinsic opponen ortho orthopaedics I am not 100% sure on how I should code this, but I am thinking …Dec 8, 2021 · Trigger Finger (trigger thumb when involving the thumb) is the inhibition of smooth tendon gliding due to mechanical impingement at the level of the A1 pulley that causes progressive pain, clicking, catching, and locking of the digit. Diagnosis is made by physical examination with presence of active triggering and tenderness at the A1 pulley. Trigger finger or thumb surgical procedure will require prior authorization effective November 1, 2023 September 14, 2023 For Medicaid plans: Effective November 1, 2023, a prior authorization will be required for CPT Code 26055 (Tendon Sheath Incision).Rt carpal tunnel release. Left trigger thumb Left small finger trigger digit injection Left trigger thumb injection. I applied: Carpal tunnel surgery 64721 RT Aspiration small joint Bursa LFT thumb- 20600 LT Injection therapeutic carpal tunnel- 20526 XSApr 24, 2024 · Trigger Finger Release with UltraGuideTFR and Real-Time Ultrasound Guidance. Using direct ultrasound visualization, identify the relevant anatomical structures of the finger and hand. After visually confirming the anatomy, UltraGuideTFR is inserted through a small incision at the distal palmar crease just proximal to the A1 pulley. Oct 1, 2010 · I hope someone can help with this. We have been back and forth with these codes. 26055 and 26145. If and went they can be billed together. Here is a short version of op-note. DX: Ring finger trigger. Tenosynovitis. An oblique incision centered over the LT ring finger A1 pulley was made in the palm. I dissected down to the A1 pulley. Coding- Trigger Finger 11 •Injection- 20550- Injection(s); single tendon sheath, or ligament, aponeurosis •Trigger Finger Release- 26055- tendon sheath incision (eg, for trigger finger) •M65.3X- Trigger Finger •M65.331-Trigger Finger, right middle finger Dupuytren’sDisease 12 Nodule Cord of fibrous tissueRight trigger thumb release (tendon sheath release). Digital nerve was retracted radially to expose the A1 pulley and under direct vision, the A1 pulley was cut. After cutting the pulley, the triggering no longer occurred. Incision was closed. A. 26075-F5 B. 26040-F5 C. 26055-F5 D. 26060-F5The CPT code for a trigger finger release is 26055. This procedure involves incising the tendon sheath of the finger to release tension in the tendon. It is important to note that CPT code 20550 is used for an injection to a single tendon sheath, ligament, or aponeurosis, while CPT code 20551 is used for an injection to a single tendon at the ...

Apr 24, 2024 · Trigger Finger Release with UltraGuideTFR and Real-Time Ultrasound Guidance. Using direct ultrasound visualization, identify the relevant anatomical structures of the finger and hand. After visually confirming the anatomy, UltraGuideTFR is inserted through a small incision at the distal palmar crease just proximal to the A1 pulley.

The‌ Current Procedural‌ Terminology‌ (CPT) code for trigger finger release is 26055, which is ‍utilized to identify ⁤and report the surgical procedure performed ⁣for this ⁢specific condition. This code covers ⁢the release of the A1 pulley at the base of⁣ the affected finger, allowing ‌for smooth tendon movement and the alleviation of symptoms.The most common CPT code for trigger finger release is 26055, which covers the release of a single trigger finger. For more complex cases, such as the release of multiple trigger fingers or a revision surgery, additional codes may be used.Jun 4, 2020 · Trigger thumb was the most prevalent at 42.22% (19 cases), followed by the ring finger 24.44% (11 cases), middle finger 22.22% (10 cases), 8.89 little finger (4 cases), and index finger 2.22% (1 case). Risk factors for TF development after open CTR were examined. We evaluated gender, age, handedness, BMI, workers’ compensation status, and ... Use this page to view details for the Local Coverage Article for Billing and Coding: Injection of Trigger Points. ... The following ICD-10-CM codes support medical necessity and provide limited coverage for CPT codes: 20552 and 20553. Group 1 Codes. Code Description; ... Trigger thumb, right thumb M65.312 Trigger thumb, left thumb …CPT code 20550 defines an injection to a single tendon sheath, or ligament, aponeurosis (eg, plantar “fascia”). CPT code 20551 defines an injection to single tendon at the origin/insertion site. Trigger finger injections are most commonly given to the flexor tendon, supporting CPT code 20550. *This response is based on the best information ...In the world of medical billing and coding, accurate CPT code descriptions are essential for ensuring proper reimbursement and maintaining compliance. CPT codes, or Current Procedu...Does anyone know what the code is for an A1 Pulley Release? Jenny. Menu. ... If pathology is Trigger finger, than code is 26055. M. mbort ... Medical Coding General ...

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The CPT code 25447, which included all interposition procedures whether with tendon, allograft, or artificial material, was the most common procedure queried, and it was analyzed as a separate group because of its adequate sample size. ... Risk of infection in trigger finger release surgery following corticosteroid injection. J Hand Surg Am ...Wiki Trigger Finger Release w/ Excision Dupuytren's Nodule. How would you code a trigger finger release with excision of dupuytren's nodule? #1 - 26160, 26055-59? #2 - 26123? The tourniquet was inflated to 200 mmHg and a 2cm bruner incision over the A1 pulley of the left ring finger and proximally over the dupuytrens disease.Does anyone know what the code is for an A1 Pulley Release? Jenny. Menu. ... If pathology is Trigger finger, than code is 26055. M. mbort ... Medical Coding General ...Best answers. 0. Aug 19, 2015. #3. Hi Dana, happy Wednesday! ok: the clinical info is just "trigger thumb". The microscopic is the part I originally posted ; the gross is "soft tissue mass right thumb / the specimen consists of a 1.3x 0.9 x 0.6cm irregular fragment of yellow-white soft tissue.."The hundreds of people attending today's Content Camp (Blogging Camp #5) heard from Kyle James, Product Manager for the blogging component of the sim Trusted by business builders w...Does anyone know what the code is for an A1 Pulley Release? Jenny. Menu. ... If pathology is Trigger finger, than code is 26055. M. mbort ... Medical Coding General ...Tendon shortening, flexor, hand or finger, single, each (26479) Thenar muscle release for thumb contracture (26508) Release, intrinsic muscles of hand (26593)CPT 26055: Tendon sheath incision (e.g., trigger finger release): This code is used for the trigger finger release procedure performed on the affected left ring finger. ICD-10 Codes: ICD 10 M65.342 : Trigger finger, left ring finger : This code documents the diagnosis of the left ring trigger finger.In the world of medical billing and coding, accuracy is crucial. One small error in assigning a Current Procedural Terminology (CPT) code can lead to significant consequences, incl...When the current procedural terminology (CPT) codes are run through the VistA integrated billing system, based on the VHA Chief Business Office Reasonable Charges, a complication can more than double the charges associated with A1 pulley surgery. ... Existing studies found complications for trigger finger release ranging from 1% to …When you undergo a medical procedure, there’s a corresponding series of numbers that medical professionals use to document the process. This Current Procedural Terminology code hel... ….

The spontaneous recovery rate for locked pediatric trigger thumb (PTT) has recently been reported at between 24% and 66%; these studies concluded that a conservative approach for this condition ...Triggers can transport you back in time to a traumatic event — but there are ways to manage them. When you encounter a trigger after trauma, a strong emotional and behavioral react...Hand Surgery CPT Codes, sorted by number. Enter your search terms Submit search ... for trigger finger) (26055) Tenotomy, subcutaneous, single, each digit (26060) ... Thenar muscle release for thumb contracture (26508) Cross intrinsic transfer (26510)Synovitis and tenosynovitis. ( M65) M65.311 is a billable diagnosis code used to specify a medical diagnosis of trigger thumb, right thumb. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.Trigger finger, right middle finger M65.332 Trigger finger, left middle finger M65.341 Trigger finger, right ring finger ... 20561 and 64625 have been added to a new CPT/HCPCS Codes section (Group 4). CPT code 64451 has been added to the CPT/HCPCS Codes section Group 3 and ICD-10 Codes that Support Medical Necessity … Right trigger thumb release (tendon sheath release). Digital nerve was retracted radially to expose the A1 pulley and under direct vision, the A1 pulley was cut. After cutting the pulley, the triggering no longer occurred. Incision was closed. A. 26075-F5 B. 26040-F5 C. 26055-F5 D. 26060-F5 diagnosis: single code only: left: right: bilateral (if available) trigger finger index : m65.322: m65.321 : trigger finger middle : m65.332: m65.331 : trigger finger ...In the healthcare industry, accurate documentation and coding are crucial for maximizing revenue and ensuring proper reimbursement. One important aspect of this process is the Nati...The most common CPT code for trigger finger release is 26055, which covers the release of a single trigger finger. For more complex cases, such as the release of multiple trigger fingers or a revision surgery, additional codes may be used. Cpt code trigger thumb release, Mar 9, 2017 · Best answers. 0. Mar 10, 2017. #3. This patient has two identifiable and separate diagnoses: Trigger Finger and PIP Joint Contracture. In order to treat both of these, your physician did two procedures: Primary: Open trigger finger release (through the standard palmer incision), and Secondary: Closed manipulation of the PIP joint. , Introduction. First described by Lorthioir in 1958, percutaneous trigger finger release (PTFR) has been advocated repeatedly as an alternative to open release [].The proponents of this technique argue that it allows for safe division without the need for incisions, resulting in decreased post-operative pain and shorter recovery [3, 1, …, Right trigger thumb release (tendon sheath release). Digital nerve was retracted radially to expose the A1 pulley and under direct vision, the A1 pulley was cut. After cutting the pulley, the triggering no longer occurred. Incision was closed. 26060-F5 26055-F5 26075-F5 26040-F5, Best answers. 0. Mar 25, 2008. #2. If the release was done through an incision try 26055; "The physician makes an incision in a tendon sheath to release tension in the tendon. (For example, this procedure would be performed to relieve trigger finger .) The physician incises the skin overlying the tendon and dissects to the tendon sheath The ..., Answer: Yes, you can report codes such as 26055 ( Tendon sheath incision [e.g., for trigger finger]) multiple times during the same procedure when appropriate. List …, 6. Best answers. 0. Feb 8, 2011. #4. 20550 says "injection (s) of a single tendon sheath...) the coding tips in the coding companion state that if more than one tendon is injected in the same incounter, each injection should be reported separately. You can bill 20550 more than once during the same encounter., Right trigger thumb release (tendon sheath release). Digital nerve was retracted radially to expose the A1 pulley and under direct vision, the A1 pulley was cut. After cutting the pulley, the triggering no longer occurred. Incision was closed. A. 26075-F5 B. 26040-F5 C. 26055-F5 D. 26060-F5 , In the healthcare industry, accurate coding is essential for proper billing and reimbursement. Two important coding systems used are CPT codes and diagnosis codes. These codes play..., There are thousands of existing codes that are updated each October. The current version is CPT 2018. But with thousands of codes out there at any given time, how can medical profe..., Fasciectomy, palmar only, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft); partial palmar excision with release of each additional digit, including proximal interphalangeal joint (26125) Excision of constricting ring of finger, with multiple Z-plasties (26596), Two similar holes were then drilled on the metacarpal head of the thumb and the tendon graft was pulled through these two hole reestablishing ulnar collateral ligaments. ... CPT code 29848 would be appropriate with modifier RT to indicate right wrist.) WRONG. Incision and drainage of tendon sheath of the right index finger. 26020 (Assign 26020 ..., Trigger Finger Codes MOST COMMON COMBO Trigger finger (727.03) Tendon sheath incision eg, for trigger finger) (26055) Coding Submenus Mucous cyst. ICD9 Codes Synovitis, hand (719.24) Trigger finger (727.03) Ganglion of tendon sheath (727.42) Contracture of joint, hand/fingers (718.44) Loc prim osteoarthritis, hand (715.14) Pain in joint, hand ..., Medical Coding General Discussion . Wiki A1 ... Does anyone know what the code is for an A1 Pulley Release? Jenny . I. Ishvindersingh Guest. Messages 16 Best answers 0. Nov 5, 2008 #2 If pathology is Trigger finger, than code is 26055. M. mbort True Blue. Messages 2,335 Location ENGLEWOOD/DENVER Best answers 0. Nov 5, …, M65.30 Trigger finger, unspecified finger - ICD-10-CM Diagnosis Codes. codes diagnosis. ICD-10-CM; DRGs; HCCs; ICD-11; SNOMED CT; ICD-9-CM; procedures. CPT ® ... Subscribe to the Find-A-Code Newsletter. Get timely coding industry updates, webinar notices, product discounts and special offers. No charge., Trigger Finger Codes MOST COMMON COMBO Trigger finger (727.03) Tendon sheath incision eg, for trigger finger) (26055) Coding Submenus Mucous cyst. ICD9 Codes Synovitis, hand (719.24) Trigger finger (727.03) Ganglion of tendon sheath (727.42) Contracture of joint, hand/fingers (718.44) Loc prim osteoarthritis, hand (715.14) Pain in joint, hand ..., Files related to Tendon sheath incision eg, for trigger finger) (26055) Find Window. X. Type in text to find: Tendon Sheath / Pulley procedure CPT Codes. Hand Surgery CPT Codes, sorted by number. Trigger Finger Codes. Dupuytrens Codes., 20550-50 51. I would not use bilateral modifier for fingers as fingers are not bilateral , you have 10. Bilateral is for paired organs or body parts. I would recommend to use either the finger modifiers or the XS modifier and list on separate lines. 20550 F2., Tendon Sheath / Pulley procedure CPT Codes. ECU Subluxation codes. Laxity of ligament (728.4) Tendon sheath incision; at radial styloid eg, for deQuervains disease) (25000) Repair, tendon sheath, extensor, forearm and or wrist, with free graft includes graft harvest (25275) Tendon sheath incision eg, for trigger finger) (26055), The official description of CPT code 26055 is: ‘Tendon sheath incision (e.g., for trigger finger).’. This code is used when a healthcare provider makes a small incision in the skin above the tendon sheath and dissects down into the sheath causing the restriction. The provider then releases the tight portion of the flexor tendon that is ..., Best answers. 0. Aug 19, 2015. #3. Hi Dana, happy Wednesday! ok: the clinical info is just "trigger thumb". The microscopic is the part I originally posted ; the gross is "soft tissue mass right thumb / the specimen consists of a 1.3x 0.9 x 0.6cm irregular fragment of yellow-white soft tissue..", CPT Codes. Surgery. Surgical Procedures on the Musculoskeletal System. Surgical Procedures on the Hand and Fingers. Excision Procedures on the Hand and Fingers. 26123. 26121. 26123., , CPT Codes. Surgery. Surgical Procedures on the Musculoskeletal System. Surgical Procedures on the Hand and Fingers. Excision Procedures on the Hand and Fingers. 26123. 26121. 26123., Oct 4, 2016 · Enter Test Code Active Test Cases. Cases. Cases ... Trigger Finger Release of the Thumb. Comments. TECHNIQUE STEPS 0 % 0. 0 ... , When the current procedural terminology (CPT) codes are run through the VistA integrated billing system, based on the VHA Chief Business Office Reasonable Charges, a complication can more than double the charges associated with A1 pulley surgery. ... Existing studies found complications for trigger finger release ranging from 1% to 31%. …, Tenotomy, open flexor or extensor tendon, forearm and/or wrist, single, each tendon (25290) Tenotomy, subcutaneous, single, each digit (26060) Excision of tendon, palm, flexor, single separate procedure, each (26170) Excision of tendon, finger, flexor separate procedure (26180) Tenotomy, flexor, single, palm, open, each (26450), Right trigger thumb release (tendon sheath release). Digital nerve was retracted radially to expose the A1 pulley and under direct vision, the A1 pulley was cut. After cutting the pulley, the triggering no longer occurred. Incision was closed. 26060-F5 26055-F5 26075-F5 26040-F5 , When the current procedural terminology (CPT) codes are run through the VistA integrated billing system, based on the VHA Chief Business Office Reasonable Charges, a complication can more than double the charges associated with A1 pulley surgery. ... Existing studies found complications for trigger finger release ranging from 1% to 31%. …, There are two CPT codes for Trigger point injections: 20552-Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) 20553-Injection(s); single or multiple trigger point(s), 3 or more muscles, I hope someone can help with this. We have been back and forth with these codes. 26055 and 26145. If and went they can be billed together. Here is a short version of op-note. DX: Ring finger trigger. Tenosynovitis. An oblique incision centered over the LT ring finger A1 pulley was made in the palm. I dissected down to the A1 pulley., INTRODUCTION. Trigger finger is an entrapment tendinopathy in which the flexor tendon catches within a thickened or narrowed A1 pulley. 1–3 With a lifetime incidence between 2% and 3% in the general population, trigger finger is one of the most common causes of disability and pain in the hand. 2, 4 Initial treatment is conservative, but …, aka “trigger thumb injection”, “trigger digit injection” Indications. Trigger Finger. ICD-9 code: 727.03 “trigger finger” (acquired) ICD-10 code: M65.3 “trigger finger“ nodular tendinous disease; CPT code: 20550 “Injection(s); single tendon sheath, or ligament, aponeurosis” Materials Needed. Pen – clicking type; Gloves ..., Best answers. 0. May 11, 2015. #1. Surgeon did a right palmar fasciectomy. then states he did trigger release rt index, rt middle and rt small fingers. My thought was 26123, and 26125 x2. However, he does specifically state that he did a release of the A-1 pulley in each of these fingers. * * * so now I am confused.