Go Back   AAPC Medical Coding & Billing Forums > Medical Coding > Orthopaedics
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 02-13-2012, 10:03 AM
karenwebb karenwebb is offline
Contributor
 
Join Date: Apr 2007
Posts: 18
karenwebb is on a distinguished road
Exclamation Tibial & Fibular sesamoidectomy

I'm trying to find this code. Doctors originally did an I & D and decided to do both a tibial and fibular sesamoidectomy. I have come across this before but I was confused on the previous.
Reply With Quote
  #2  
Old 02-17-2012, 05:16 AM
PICFLORIDA49 PICFLORIDA49 is offline
Contributor
 
Join Date: Apr 2007
Posts: 11
PICFLORIDA49 is on a distinguished road
Default sesamoidectomies

I am also needing to know how to code an I&D with tibial and fibular sesamoidectomies. Please let me know if you find out anything. Thanks.
Reply With Quote
  #3  
Old 02-17-2012, 06:39 AM
Jamie Dezenzo Jamie Dezenzo is offline
True Blue
 
Join Date: Apr 2007
Posts: 791
Jamie Dezenzo is on a distinguished road
Default

could you post note?
Reply With Quote
  #4  
Old 02-20-2012, 03:25 AM
PICFLORIDA49 PICFLORIDA49 is offline
Contributor
 
Join Date: Apr 2007
Posts: 11
PICFLORIDA49 is on a distinguished road
Default I&D with Fibular Tibial Sesmoidectomies

PROCEDURE IN DETAIL: Under mild sedation, the patient was brought to the operating room and placed on table in supine position. Pneumatic tourniquet was placed about the patient's right ankle. Following general anesthesia, local anesthesia was obtained throughout the patient's right foot utilizing 0.5% Marcaine plain. The foot was scrubbed, prepped and draped in usual aseptic manner. An Esmarch bandage utilized to exsanguinate the patient's foot and the pneumatic tourniquet was then inflated.

Attention was then directed to plantar aspect of the right foot where the area of previous drainage was noted. This area was dissected and elongated with resection of ulcerative tissue. This incision was carried down to the fibular sesamoid where there was noted inflammatory tissue within the plantar aspect of the right foot. The fibular sesamoid was identified. It was significantly hypertrophied and degenerated. This was resected from its surrounding soft tissue structures and passed off the operative field and sent to pathology for both gross and microscopic examination as well as cultures taken.

At this time, the decision was made to resect the tibial sesamoid secondary to the fact that this will be cause of increased pressure in the future especially with respect to the fibular sesamoid and the patient's long history of current resections and ulcerations. This was done without incident. Upon completion of the procedure, the area was flushed with pulse lavage with 1 L with bacitracin followed by appropriate closure. There was an area that was unable to close. This was packed with half-inch Iodoform gauze to be removed by myself in my office. Appropriate dressings were applied, followed by release of the pneumatic tourniquet and hyperemic response to the remaining stump of the right foot.
Reply With Quote
  #5  
Old 05-08-2013, 10:04 AM
Marie Martin Marie Martin is offline
New
 
Join Date: Apr 2007
Posts: 4
Marie Martin is on a distinguished road
Default tibial sesamoidectomy

Hope this helps. Found my answer elsewhere. Use CPT code 28315.


Patho-Anatomy:
- turf toe
- sesamoid fractures
- hallux valgus
- because the sesamoids are eembedded in teh tendon of the FHB, which inserts into the base of the proximal phalanx, any degree of hallux valgus tends to rotate both sesamoids on the long axis;
- fibular sesamoid tends to rotate into the 1st metatarsal interspace, thereby disposing of the possibility of its becoming a wt bearing focus;
- tibial sesmoid rotate on its side & thus become wt bearing pivot;
- sesamoiditis
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 08:18 PM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC