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 11-05-2008, 03:37 PM
abevan abevan is offline
Contributor
 
Join Date: Apr 2007
Posts: 15
abevan is on a distinguished road
Default achilles tendon debridement with retrocalcaneal bursectomy

I am looking for a CPT for debridement achilles??
Reply With Quote
  #2  
Old 11-05-2008, 03:54 PM
mbort's Avatar
mbort mbort is offline
True Blue
 
Join Date: Apr 2007
Location: ENGLEWOOD/DENVER
Posts: 2,333
mbort is on a distinguished road
Default

there is not a code for "achilles debridement" specifically. Can you post the scrubbed version of the op note?
Reply With Quote
  #3  
Old 11-05-2008, 03:56 PM
abevan abevan is offline
Contributor
 
Join Date: Apr 2007
Posts: 15
abevan is on a distinguished road
Default

The skin was incised with a #10 blade. Full-thickness flaps were created with minimal trauma and no-touch technique. Dissection was carried down through the paratenon, which was split longitudinally. The paratenon was then reflected off the distal Achilles tendon. The distal portion of the tendon was carefully exposed. The tendon was then split longitudinally and inspected.

The distal most insertion had some mild degenerative changes identified within the tendon along with a large posterior-superior Haglund prominence. The distal insertion was partially detached and peeled back in the split. The degenerative portion of the tendon was debrided. This was a minimal portion of the tendon and the overall strength was felt not to be compromised. As such, it was not deemed necessary for a flexor hallucis longus tendon transfer. The deep surface of the tendon was meticulously debrided. The insertion site was exposed.

The oscillating saw and osteotomes were used to perform an exostectomy of the posterior-superior Haglund prominence. This was carefully contoured medially and laterally. Small pump-type bump laterally was debrided and taken down. The tendon was not detached in its entirety. Following adequate decompression of the posterior-superior calcaneus and debridement of the Achilles tendon, the tendon was then reattached with three G-2 Mitek bone anchors.

The Achilles tendon was then stabilized down to the bone anchors and oversewn. The lateral border and lateral pump bump area were reinforced then with #2 Ethibond suture through bone and oversewn with #0 PDS suture. The longitudinally split portion of the tendon was partially reapproximated with the bone anchors and the #2 Ethibond. Final repair was with #0 PDS suture.

A solid insertion site was obtained having been thoroughly debrided and the retrocalcaneal bursa debrided. The wound was copiously irrigated throughout the course of the procedure. The paratenon subcutaneous tissues were reapproximated with 4-0 Vicryl and final skin closure with interrupted 4-0 nylon sutures with good apposition and minimal tensioning.
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 01:26 AM.

AAPC - Top

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