could someone please help on coding this op report:
pt is approx 1 yr staus post ulnar styloid fx which has not healed2cm incision was made over the ulnar styloid on the dorsal ulnar skin and the subq tissue dissected. I then idenified the extensor carpi radialis. I resected and excised the periosteum exposing the distal ulnar styloid in the nonunion site, which is fibrous union. I debrided this, curetted the ends of the bone and scraped to get the surface bleeding. I then reduced this and held in placeas i advanced the kwire of 1.0mm. I then measured this and resected a 20mm with a longer Acutrak screw. I did not feel the screw head in the ulnar styloid enough to advance with the mini Acutrak. for this reason, I again drilled the bone w/ the driller and advanced 2.8mm x 20mm Acutrak screw compressing the nonunion site. I cked the position and it was satifactory w/ no gross instability of the distal radialulnar joint and no clicking. I irrigated and repaired the periosteum with 3-0 Vicryl interuppted inverted sutures.
My question is , one I bill for an ASC, the physician gives me CPT 25652, but i feel the this is a repair of a nonunion wouldnt 25400 be more appropriate?
pt is approx 1 yr staus post ulnar styloid fx which has not healed2cm incision was made over the ulnar styloid on the dorsal ulnar skin and the subq tissue dissected. I then idenified the extensor carpi radialis. I resected and excised the periosteum exposing the distal ulnar styloid in the nonunion site, which is fibrous union. I debrided this, curetted the ends of the bone and scraped to get the surface bleeding. I then reduced this and held in placeas i advanced the kwire of 1.0mm. I then measured this and resected a 20mm with a longer Acutrak screw. I did not feel the screw head in the ulnar styloid enough to advance with the mini Acutrak. for this reason, I again drilled the bone w/ the driller and advanced 2.8mm x 20mm Acutrak screw compressing the nonunion site. I cked the position and it was satifactory w/ no gross instability of the distal radialulnar joint and no clicking. I irrigated and repaired the periosteum with 3-0 Vicryl interuppted inverted sutures.
My question is , one I bill for an ASC, the physician gives me CPT 25652, but i feel the this is a repair of a nonunion wouldnt 25400 be more appropriate?