Pre-op DX: Index, Long, Ring, and Small flexor tenosynovitis

Post op DX: Index, Long, Ring, and Small A1 pulley release and flexor tenosynovectomy.

Procedure: Index, Long, Ring, and Small A1 pulley release and flexor tenosynovectomy.

Procedure: A 15 blade was used to make a transverse incision to level of A1 pulley. This was carried down to subcutaneous tissue using tenotomy scissors. The neurovascular bundles were identified on each side of the fiber osseous sheath and retracted with nerve retractors placed within the confines of the wound. Once the A1 pulley was identified, an axial incision was made in the midline of it dividing it completely. This was carried proximally and distally with tenotomy scissors. Tenotomy scissors were used to perform FLEXOR TENOSYNOVECTOMY for the index, long, ring and small fingers. After this was done again the neurovascular bindles were inspected and found to be intact. The Ragnell retractor was used to pull the tendon into the wound to ensure that it had been completely released from the pulley. The tourniquet was let down. Sterile dressing was applied.

I realize it says the Dr. checked to see that the tendon was released from the pulley, but wouldn’t I code for the tenosynovectomies (26145) and use tenosynovitis (m65.842) as my DX? The A1 pulley release cpt code is 26055 is for trigger finger. And trigger finger and tenosynovectomy are inclusive of each other. For the office visits prior to the surgery the Dr. is using the trigger finger dx. So what should I be coding this as?