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Orthopedic Coding Alert

Reader Question:

Report Reconstruction for Ray Excision in Toe

Question: Please help with the diagnosis and procedural coding for the procedure mentioned below.Post-operative diagnosis: Left foot first metatarsal extra ray polydactyly. Operations performed: Left foot first metatarsal extra ray excision and osteotomy. The operative note follows:"The left leg was elevated and an Esmarch bandage was used to exsanguinate the foot, ankle, and lower leg region and used as a tourniquet above the ankle. Through the old incision between the first and second rays in the web space extending back toward the proximal end of the metatarsals, an incision was made and taken down through subcutaneous tissue. Dissection was continued down to the bone. X-ray was obtained. Bleeders were clamped and cauterized in the usual manner. It was noted that the mass was very cartilaginous as well as being hard and actually bigger than what was suggested by the bony aspect of it that was on x-ray. A fluoroscopic examination [...]

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