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I have a physician that is looking for a code for an ALL knee surgery. (Anterior Lateral Ligament) The code it keeps throwing me to is for an ACL surgery and he says that is not the same surgery he is doing on this particular ligament. I am looking for an open code for this procedure so that we can bill this properly on the surgeons side and our surgery center.
Thanks for any help you can give! 
Kimmy
I have a physician that is looking for a code for an ALL knee surgery. (Anterior Lateral Ligament) The code it keeps throwing me to is for an ACL surgery and he says that is not the same surgery he is doing on this particular ligament. I am looking for an open code for this procedure so that we can bill this properly on the surgeons side and our surgery center.
Thanks for any help you can give!
Kimmy
Thank you!
I think I’ve brainstorming stuff this time. The patient was in an accident (traumatic). This is the first time that this malunion of deltoid ligament of the right ankle has been observed. There was no documentation of earlier repair that could’ve resulted in such malunion.
Were it a bone fracture I would code with the ICD-10-CM Code for that fracture with initial encounter (following the concept of delay in treatment and hence the initial encounter code rather than the subsequent encounter malunion code). But in this case surprisingly the physician has stated the term malunion for a ligament.
1. I’m thinking of going with S93.421A. The problem is that the physician has not stated the term sprain explicitly.
2. Also, I was wondering about what the code would be if the ligament was repaired earlier and now presented with malunion? Would we code sprain subsequent encounter then or would we code through complication-postprocedural route? There is no code as such for sprain-ligament-subsequent encounter-malunion.
Am I wrong in extrapolating the fracture malunion concept to ligament malunion diagnosis?
Any thoughts?
…………….I made a 5 mm incision in the left upper quadrant through a previous incision site into the abdomen with a Veress needle, insufflated 14 mmHg, placed a 5 mm port. There was some adhesions down above the umbilicus, placed a port in the left lower quadrant and one in the right upper quadrant through previous incision sites, got in, took down those adhesions and then looked at the falciform ligament, we used a laparoscopic Metzenbaum to take down the falciform ligament, mobilizing it, placed a 22-gauge needle through the umbilicus, identifying which was then cleaned off the peritoneum in that area. Once that was done, we placed traction on the umbilicus, found a small fistulous tract and opened that track up with the Bovie as well. There was essentially no blood loss to speak of. We closed all wounds with running subcuticula sutures of 4-0 Vicryl and placed a sterile dressing in the umbilicus.
laparoscopic robotic uterosacral ligament fixation involving suspending the vaginal apex from shortened, plicated uterosacral ligaments in a manner analogous to the vaginal uterosacral ligament fixation.
Everything that I am finding points to using the unspecified procedure 58999. The closest CPT I find is 57283 (colpopexy vaginal, intraperitoneal).
I have a urogyencology office which is looking to utilize this procedure a lot and I need to find the best way to code this. I have never had to bill out an unspecified procedure before and I need guidance of how this is to be done.
Any help/guidance will be greatly appreciated.
Thanks everyone!
laparoscopic robotic uterosacral ligament fixation involving suspending the vaginal apex from shortened, plicated uterosacral ligaments in a manner analogous to the vaginal uterosacral ligament fixation.
Everything that I am finding points to using the unspecified procedure 58999. The closest CPT I find is 57283 (colpopexy vaginal, intraperitoneal).
I have a urogyencology office which is looking to utilize this procedure a lot and I need to find the best way to code this. I have never had to bill out an unspecified procedure before and I need guidance of how this is to be done.
Any help/guidance will be greatly appreciated.
Thanks everyone!
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