Argon Beam Ablation

Nova

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Can anyone help me on a CPT code for an argon beam ablation, per UHC there is a more specific CPT code then the unlisted 27599 that I have billed out. Any advise, I would greatly appreciat it? Thank you Nova
 

mbort

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can you post the scrubbed op note? Unfortunately I am unable to assist without additional information about the case.
thanks
Mary
 

Nova

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OP REPORT "argon beam"

OP NOTE:
The patient was consented in the normal fashion. He wsa taken back to the operative suite and he was placed in the right decubitus position. His entire left leg was sterlely prepped and draped in the normal sterile fashion.

His fibular head was identified and using a marking pen an approximately 8-cm incision was marked anterior to his fibular head starting in the metaphyseal area of his left distal femur and extending toward the tibial tuberosity. Using sharp dissection the skin and subcutaneous tissue was sharply dissected down until the iliotibial band was encountered. Using a Bovie the iliotibialband was split longitudinally and the vastus lateralis and the lateral femoral condyle were then encountered. At this time the soft tissue mass was encountered as well. Using a 15 blade an approximately 4 cm X 2 cm ellipse of cortical bone was taken out followed by an aprroximately 4 cm X 2 cm intramedullary portion of the giant cell tumor was taken. this was walked down to pathology by Dr. Mallin and read by pathology as a preliminary report to be giant cell tumor of bone. Following this attention was again then turned to the intramedullary giant cell tumor which was curetted out thoroughly using a curette and spoon. when all of the material was evacuated a cureete was then used to curette the part of the bone. Following this a cutting bur was used to bur all of th remaining tissue that appeared to be giant cell like as well as the intramedullary cortical area of bone. Following the the argon laser was used to coagulate all the intramedullary area of bone that was exposed to the giant cell tumor.

Following the bone chips were then morselized and placed in the subchondral area of all of the articular portion of the distal femur and two batches of cement were then placed within the cavity that was left behind by the giant cell tumor. A pproximal tibia AO plate was then placed on the distal femur and contoured to the contour of the lateral femoral condyle of the distal femur. Two 4.5 cortical screws were placed into the diaphysis of the distal femur to buttress this cement and bone chips into the distal femur. Following this the wound was thoroughly irrigated and debrided. Using 0 vicryl sutures the iliotibial band was sutured and staples were used to close the skin. Prior to the closure of the subcutaneous tissue two Homovac drains were placed and taken out just distal to the incision through the skin in the line of the incision. Xeroform and 4X4's were then placed, sterile cast padding was then wrapped around the entire leg as well as two six inch Ace bandages. The patient was extubated and taken to the PACU in stable condition. Dr. Mallin was present for all parts of the operative procedure.
 
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