2nd Interspace decompression

Zumwalta

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Hello,

I am trying to find the best code for a decompression of the deep transverse ligament at the 2nd metatarsal interspace. The provider did not remove a neuroma just released the deep transverse ligament. I have researched and keep coming across codes for 64704, 28080, and 29999. I hesitate to use 64704 because it is a ligament not a nerve and I also hesitate on 28080 because no neuroma was excised. If I use unlisted 29999 would it be most like 28080 (our billing department sets up the unlisted code based off the procedure most like the procedure performed) since the decompression of the ligament is typically included in the neuroma excision? There is no pathology report because nothing was excised. However, the provider also did a Left 2nd Plantar plate tear and a weil osteotomy on the 2nd metatarsal, would the decompression be included in this procedure or would it be considered separate? Any help is greatly appreciated

OP NOTE
PRE OP DIAGNOSIS: Left 2nd Plantar plate tear and 2nd interspace neuroma
POST OP DIAGNOSIS: Same
PROCEDURE: 1. 2nd plantar plate repair
2. Weil osteotomy 2nd metatarsal
3. 2nd Interspace decompression.
ANESTHESIA: General

Attention was direction to the 2nd MPJ of the left foot where a z incision was made over the MPJ. Dissection was bluntly performed to free the 2nd MPJ. The Collateral ligaments were released sharply. Next the periosteum was elevated from the neck of the 2nd metatarsal.
*A weil was then performed with a sagittal saw. The head was pushed proximally. This was fixated with a K-wire and mini hinterman with another k-wire in the base of the proximal phalanx was used to distract the joint. A tear in the plantar plate was observed centrally. The plate itself was largely healthy in appearance. The plate was released from the base of the proximal phalanx.
*Next the hat trick was used to suture the plantar plate. A central guide hole in the base of the phalanx was used and the suture was passed through and the toe was tensioned down. A peak interference screw was then placed.
*A 2.5 fixos screw was used to fixate the weil. The step off was removed.
*Next attention was directed to the 2nd interspace. The deep transverse ligament was released. The common plantar digital nerve was observed. It appeared to be healthy and of normal size.
*The wound was irrigated with saline. The subcutaneous tissue was repaired with 4-0 monocryl. The skin was repaired with 4-0 prolene. A dressing of xeroform, 4x4's, kerlix and coban was applied.
 
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