After receiving helpful advice from a fellow member, have come across another scenario that is baffling due to my limited experience in this type of coding.
PRE-OP DX: ischemic ULCER RIGHT LATERAL FOOT
post-op dx: osteomyelitis WITH ISCHEMIC ULCERATION OF RIGHT LATERAL FOOT INVOLVING 4TH AND 5TH METATARSAL AND CUBOID BON
Performed:
1) debridement of right foot to include skin & soft tissue and cuboid bone right foot.
2)Right 5th metatarsal resection, partial
3) right 4th metatarsal resection, partial
Description: (extraction of pertinent verbiage). Ischemic ulceration was then debrided over the lateral foot. This clearly involve the 5th metartarsal bone.
Wound did extend more medially w/involvement of the cuboid bone as well as the 4th metatarsal. These were all sharply debrided back with a rongeur and
the 5th metatarsal was resected along with a portion of the 4th metatarsal. Would was packed w/saline-good bleeding was appreciated from wound bed.
My efforts: I see a debridement here in #1, but not sure about the two codes for #2 and #3. I’m thinking 28122, 28122. (The 5th metatarsal was resected, with a portion
of 4th?), so not sure about choosing the same code for both procedures when one was a partial.
Can anyone offer guidance?