louise Posted Fri 08th of March, 2019 11:06:29 AM
The first digit was approached first, by drawing out the multiple z-plasty incision with a surgical pen. Lidocaine 1% was injected in the incision line and then a #15 blade was used to make the skin incision and raise the flaps. Hemostasis was obtained and the wound was closed with interrupted PDS sutures in its new geometric configuration. The contractures at the level of the PIP joint palmar surface of digits #2,3,4,5 were released with a#15 blade and closed capsulotomy was performed. Non-threaded K-wires were placed across the PIP joint. Donor was harvested from the left thigh and treated as a sheet. These grafts were then secured in the wounds with interrupted suture. The left wrist was rel;eased with a running z-plasty and incision was closed with interrupted suture. Grafts and incision were dressed with xeroform surgicals. Coder coded as follow: z-plasty left hand digit #1 (4 cm x 2 cm) 14041
Contracture release & STAG digits #2,3,4,5 (2 cm x 2 cm each digit) 26123 x4
Closed capsulotomy digits #2,3,4,5 26525x4
SuperCoder Answered Mon 11th of March, 2019 09:31:04 AM
Thanks for your question.
The payment might have denied since the coder coded 4 units of 26123 which is not correct as the MUE of 26123 is only 1. Secondly, code 26525 have a MUE value of 4 therefore it is appropriate. Also, same location cannot be billed together.
Hope this helps.