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Forearm Procedure

L Posted Sun 29th of March, 2015 21:50:48 PM

How would I code the following:
DIAGNOSIS: Right forearm posttraumatic pain with symptomatic, retained plate and distal radioulnar joint arthrosis.

POSTOPERATIVE DIAGNOSIS: Same as above with contracture and bowstringing FCR.

PROCEDURE:
1.Removal, retained plate and screws from radius shaft, deep (plate and 6 screws), right.
2.Fractional lengthening of the flexor carpi radialis tendon.
3.Corticosteroid injection to the right distal radioulnar joint.

Thanks.

SuperCoder Answered Mon 30th of March, 2015 01:16:28 AM

ICD-9-CM codes:
1. ICD-9 code 338.21 for Right forearm posttraumatic pain with symptomatic.
2. ICD-9 code 728.85 for contracture and bowstringing FCR.
3. ICD-9 code 996.49 for retained plate.
4. ICD-9 code 715.13 for distal radioulnar joint arthrosis.

CPT codes:
1. CPT code 20680 with -RT modifier should be used for removal, retained plate and screws from radius shaft, deep (plate and 6 screws), right.

2. CPT code 25280 should be used for Fractional lengthening of the flexor carpi radialis tendon.

3. CPT code 20605 should be used for Corticosteroid injection to the right distal radio-ulnar joint, but it is considered included in the primary procedures. As corticosteroid injections are considered to be post-operative pain management procedure and are not separately reimbursed.

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