Procedure 3 cotton osteotomy right foot medial cuneiform:
Attention was then drawn to the dorsal aspect of the right foot where a 5 cm was generated over the medial cuneiform. Dissection was carried down to the level of the periosteum of the medial cuneiform using a combination of sharp and blunt dissection. Transverse osteotomy was performed, and a metatarsal spreader was used to help relax the soft tissues on the plantar most surface of the medial cuneiform. A Hintermann was introduced to allow for enhanced distraction and a size 6 cotton wedge bone graft was introduced to the medial cuneiform. Prior to doing so, 3 mL of bone marrow aspirate was introduced into the osteotomy site, bathing both the graft as well as the inferior surface. Temporary fixation came in the form of a 0.062 K-wire that was introduced proximal to distal. The wound was irrigated and closed. Prior to doing so, bone putty osteoconductive material was packed around the graft.
Procedure 6 bone marrow aspiration right heel:
Prior to insufflation of the tourniquet, a Jamshidi needle was introduced to the lateral aspect of the body of the tuberosity of the calcaneus. Under negative pressure, 5 mL of bone marrow aspirate was obtained for introduction to both the calcaneal osteotomy as well as the cotton osteotomy site. Once the bone marrow aspirate was obtained, the wound was irrigated and closed in the usual fashion. The patient was then taken to the PACU with neurovascular status intact to the right foot and ankle. The patient tolerated the procedure and the anesthesia well.
There is disagreement in our office as to what the bone marrow aspiration should be coded as:
38220 which the Coder’s Desk Reference says is diagnostic and sent out to be analyzed which he did not do
or
38232 which is more for harvesting for use in an actual transplant
or
0232T PRP which can be by blood or bone marrow but he did not state he spun it down
Any help would be appreciated