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TN.8.190

Definitions - Hand and Wrist Items

Explanatory note · departmental guidance

Note TN.8.190
  • Ray: From the tip of the digit to proximal metacarpal base of that digit, including phalanges and metacarpal.
  • Index ray: First web in Dupuytren contracture releases is considered part of the index ray.
  • Primary: Acute injury and first management of a pathology.
  • Secondary: Delayed or subsequent to primary treatment, or occurring after normal expected relevant tissue healing time.
  • Vascular graft: Harvesting of graft, insetting and anastomosis of both ends of graft.
  • Nerve graft: Harvesting of graft, insetting and neurorrhaphy at both ends of graft.
  • Tendon graft: Harvesting of graft, insetting and tensioning of graft and tendon weave/repair at both ends of graft.
  • Transcarpal amputation: Includes the hand through the radiocarpal, midcarpal or carpometacarpal joints.
  • Wrist joint: Includes radiocarpal, midcarpal and radioulnar joints, which are not to be billed independently.
  • Z-plasty: Raising, transfer, insetting and suturing of both components (flaps) of the Z-plasty procedure.
  • Flexor tendon: A tendon on the volar aspect of the digits, hand or wrist.
    – Treatment of only two flexors can be claimed per digit/ray.
    – The two slips of flexor digitorum superficialis (FDS) inserting to the middle phalanx are not to be claimed as two tendons and are to be billed as part of the single FDS tendon.
  • Nerve Trunk: A bundle of nerve fibres enclosed in a connective tissue sheath.

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Applies to 5 items in this tool
As at 1 Aug 2026