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Orthopedic Coding Alert


Look at 10060/10061 With 26445 for I&D, Tenosynovectomy

Question: The surgeon performed irrigation and debridement for a right hand abscess and completed extensor tenosynovectomy close to the wrist. Documentation recorded a "rather dense collection of phlegmon in scar tissue which appeared to be in a subcutaneous layer overlying the extensor tendon. Loculations were disrupted with examining finger and nodular tissue was debrided and sent to pathology. There was an apparent intense synovitis surrounding the extensor tendons that was sharply debrided." How should I code this procedure? Florida Subscriber Answer: Choosing a code for the extensor tenosynovectomy gets tricky because CPT doesn't have a good hand code for this procedure on the dorsum. Check the surgeon's documentation and verify the location, but 25028 (Incision and drainage, forearm and/or wrist; deep abscess or hematoma) and 26445 (Tenolysis, extensor tendon, hand OR finger, each tendon) could apply if you're close enough to the wrist to use a wrist cod -- Reader Questions [...]

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