kamer330
Contributor
My provider is requesting that I bill both 14040 and 28285 for the correction of the same toe even though there is an edit. I do not believe the documentation supports it.
The Dx provided are adductovarus deformity, left fifth toe and hammertoe deformity, left fifth toe.
Attention was next directed towards the dorsal aspect of the left fifth toe where a distal medial to proximal lateral incision was made and an elliptical incision around the PIPJ and the skin was excised out in toto measuring approximately 2 x 1 cm. Next, the extensor tendon was identified and extensor tenotomy was performed and the PIPJ was exposed. A sagittal saw was utilized to resect the proximal phalanx head and the incision was irrigated with copious amount of sterile normal saline. After the arthroplasty was complete, attention was next directed back towards the skin. The skin was undermined proximally and distally and medially and laterally until the toe could be derotated into more correct alignment as the toe nail facing laterally. After undermining circumferentially, the distal tissue was advanced proximally along with the extensor tendon utilizing 3-0 Monocryl and 3-0 nylon suture in a horizontal mattress suturing technique. After rearrangement of adjacent soft tissue, the incisions were irrigated with copious amount of sterile normal saline and final closure was performed with 3-0 nylon suture.
Any input would be appreciated.
The Dx provided are adductovarus deformity, left fifth toe and hammertoe deformity, left fifth toe.
Attention was next directed towards the dorsal aspect of the left fifth toe where a distal medial to proximal lateral incision was made and an elliptical incision around the PIPJ and the skin was excised out in toto measuring approximately 2 x 1 cm. Next, the extensor tendon was identified and extensor tenotomy was performed and the PIPJ was exposed. A sagittal saw was utilized to resect the proximal phalanx head and the incision was irrigated with copious amount of sterile normal saline. After the arthroplasty was complete, attention was next directed back towards the skin. The skin was undermined proximally and distally and medially and laterally until the toe could be derotated into more correct alignment as the toe nail facing laterally. After undermining circumferentially, the distal tissue was advanced proximally along with the extensor tendon utilizing 3-0 Monocryl and 3-0 nylon suture in a horizontal mattress suturing technique. After rearrangement of adjacent soft tissue, the incisions were irrigated with copious amount of sterile normal saline and final closure was performed with 3-0 nylon suture.
Any input would be appreciated.