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Orthopedic Coding Alert

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Check Extent of Erosion in Tumor Excision

Question: Our surgeon did a planned release of an A-1 pulley with excision mass over DIP joint, and ended up releasing both A-1 and A-2 pulleys.  The mass over the DIP joint was followed from the subcutaneous tissue down to the joint level. It extended through the joint, causing erosion at the dorso radial aspect of the middle phalanx. The bone surface with the erosion was debrided releasing A-1 pulley. Can we report code 26055 (Tendon sheath incision [e.g., for trigger finger])? Can we report 26116 (Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial [e.g., intramuscular]; less than 1.5 cm) for the mass excision? The surgeon did not purposely open the joint to remove the mass, but after removing it, he saw the mass (turned out to be rheumatoid nodule) had eroded the joint. How do we report this? New York Subscriber Answer: Since the mass [...]


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