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Repair of collateral ligament DIP joint CPT help

Wondering if anyone can help validate the codes below.

CPT 26545 , 26410, and 13131 were coded… shoudl it be 26418?

Assessment: Left index finger laceration with tendon and ligament injuries. have recommended a wound exploration and repair of injured structures. Verbal consent was obtained. The procedure included complex wound repair, extensor tendon repair in zone 2, 1.

Procedure:
The hand was prepped and draped in the standard sterile fashion. A digital nerve block using 2% lidocaine was performed. The wound was extended radially and ulnarly and skin flaps were raised. The extensor tendon was found to be lacerated 100% through both lateral bands distal insertion. There was also a partial laceration of the collateral ligament on the radial aspect. The skin flaps were temporarily sutured in place for retraction.

The wound was copiously irrigated with Betadine saline. The ligament was reapproximated using a 4-0 Ethibond suture in a figure-of-eight fashion. The extensor tendon was repaired with a modified Kessler core suture with 4-0 PDS. There suture is reinforced with an epitendinous suture of 6-0 Prolene in a running interlocking horizontal mattress fashion. The wound was then once again irrigated. The skin was closed using 5-0 nylon sutures. The finger was noted to be in a fully extended position following the repair. The finger tourniquet was removed and good capillary refill was noted distally. The patient was placed into a finger DIP extension splint. He tolerated the procedure well and was given antibiotics and instructions to follow up in my office later this week.

Thanks :)

Fiona

Medical Billing and Coding Forum

Medial collateral ligament lengthening & bone marrow venting

Does anyone know if I can use 29879 for the above procedure or should I use unlisted 29999 or would this be considered part of 29882? Has anyone heard of bone marrow venting?
Op Report: Anterolateral portal established–Patellofemoral trochlear surfaces normal as well as medial lateral gutters. Medial joint line was entered. A valgus stress was applied. We saw the radial-type tear of the posterior horn & body junction of the medial meniscus. An anteromedial portal was established parallel to tibial plateau. We noted the superior articular edge of the tear was approximately 50% whereas the undersurface tear was nearly 100% of the meniscus. We used a shaver, rasp & needle to trephinate the capsular tissues. We also used a spinal needle 18-gauge to trephinate the medial collateral ligament to allow for a medial collateral ligament lengthening procedure so that we could enter the medial compartment without damaging the articular surfaces of the medial femoral condyle or tibial plateau. We then from both the anterolateral & anteromedial portal used a Arthrex scorpion device to place vertical mattress sutures across the radial tear. The sutures were tied with sliding & locking knots with alternating half hitches & post. A total of 4 sutures were inserted. There is anatomic approximation of the medial meniscus tear. The ACL & PCL were intact. The lateral meniscus, lateral femoral condyle & tibial plateau articular surfaces were normal. We then used a 45 degree awl to perform a bone marrow venting procedure of the lateral femoral condyle just anterior to the anterior cruciate ligament insertion site. Following this the water was turned off. There was bone marrow & blood extravasating from the bone. Wounds were closed, steri-strips applied & dressings applied.

Medical Billing and Coding Forum

Percutaneous medial collateral ligament release in arthroscopic medial meniscectomy

I am new to Orthopaedics. Op: ATS partial MCL ligament release with medial meniscectomy. I get 29882 and am wondering if the MCL ligament release is bundled with the 29882? MCL liagment release 27427?? Thank you in advance

Medical Billing and Coding Forum