Cathy Posted Tue 17th of March, 2015 17:39:19 PM
I have a question concerning how to code the following procedure:
Revision of right Burton arthroplasty with placement of Arthrex Mini TightRope implantable system.
Indication for Procedure:
Pt with a previous Burton arthroplasty of the right wrist. Having pain and on x-ay had subluxation of the metacarpal to the scaphoid. Has wrist pain as well. Decision made for surgery; pt agrees and consents
Description of Procedure:
Pt brought to OR and placed in supine position. GA administered. Arm prepped and draped ................... dissection carried down bluntly through the skin and the capsule was identified. Division was carried down and the old FCR tendon graft was noted. This appeared to be bulging out away from the metacarpal-scaphoid junction. This tendon was dissected away from surrounding area. There appeared to be enough trapezoid in close proximity that some rongeuring was performed to prevent impingement. ROM was performed, the mini C-arm used to visualize that there was no adjacent bone to the scaphoid. Next the Arthrex Mini TightRope system was then opened and a 0.062 K-wire was passed through the 2nd metacarpal at the base. The thumb was in distraction and slight pronation when this was placed. Next the guidewire was passed through there with the suture in place. Positioning of the wire was checked with C-arm prior to placing this suture as well. Next, the metal button on the ulnar side of the 2nd metacarpal was placed over the suture wire as well. The knot was then covered with interosseous muscle and fascial plane. C-arm was checked. Good distraction and positioning was noted. The excess tendon was then placed down into the bony defect, and the capsule was closed with 3-0 Monocryl in an interrupted fashion and Steri-strips. A thumb spica splint was placed. The patient tolerated the procedure well. The Mini TightRope 1.1-mm inplantable system was used.
SuperCoder Answered Wed 18th of March, 2015 08:06:37 AM
AAE does not provide coding for operative reports and chart notes.
SuperCoder offers SuperCoding on Demand (SOD) (http://www.supercoder.com/coding-answers/coding-on-demand) for coding of an operative report or chart note and you can contact (866)228-9252 or e-mail email@example.com for more information.