My MD submitted a billing for "Bilateral Chevron Type Bunionettectomies" - I can not find a code that mets these, can someone point me in right direction?
Details from the Op Report:
Description of the Operation:
After successful induction, bilateral lower extremities were prepped and draped. The left foot was addressed first. Gravity exsanguination, placing the tourniquet.
A longitudinal incision over the dorsum of the fifth toe, dissecting down, reflecting soft tissues off the fifth lateral proximal phalanx distal and we took a rongeur and removed this. We contoured it. We closed the skin with interrupted Nylon.
We made a dorsolateral incision over the fifth MTP, dissecting down, swept the neural element inferiorly, out cut the capsule, shaved the eminence off in line with the shaft and then made an oblique osteotomy 60 degrees, short-arm superiorly along the long arm inferiorly, shifted the head medially, placed a pin from proximal to superior to inferior distal medial. This pinned the osteotomy site. Removed the overhang of bone proximally and closed the capsule with Vicryl, closed the skin with interrupted Nylon, infiltration of Marcaine, Adaptic and Betadine. The side the tourniquet let down.
Inflated the tourniquet on the right and did the identical operation on the right dorsal incision fifth, dissecting down removing the distal proximal phalanx condyle, dorsolateral incision, dissected down protecting the neural element, out cut the capsule, shaved the eminence off, made an oblique osteotomy, shifted it again and pinned it and removed the overhang of bone. Closed the capsule with Vicryl, and closed the skin with interrupted Nylon, infiltration of Marcaine, Adaptic and Betadine and a compressive dressing applied.
Postoperative Plan: The plan is to have the patient weightbearing foot flat, dressings off in 3 days. Followup in the office in 10 to 14 days.
Details from the Op Report:
Description of the Operation:
After successful induction, bilateral lower extremities were prepped and draped. The left foot was addressed first. Gravity exsanguination, placing the tourniquet.
A longitudinal incision over the dorsum of the fifth toe, dissecting down, reflecting soft tissues off the fifth lateral proximal phalanx distal and we took a rongeur and removed this. We contoured it. We closed the skin with interrupted Nylon.
We made a dorsolateral incision over the fifth MTP, dissecting down, swept the neural element inferiorly, out cut the capsule, shaved the eminence off in line with the shaft and then made an oblique osteotomy 60 degrees, short-arm superiorly along the long arm inferiorly, shifted the head medially, placed a pin from proximal to superior to inferior distal medial. This pinned the osteotomy site. Removed the overhang of bone proximally and closed the capsule with Vicryl, closed the skin with interrupted Nylon, infiltration of Marcaine, Adaptic and Betadine. The side the tourniquet let down.
Inflated the tourniquet on the right and did the identical operation on the right dorsal incision fifth, dissecting down removing the distal proximal phalanx condyle, dorsolateral incision, dissected down protecting the neural element, out cut the capsule, shaved the eminence off, made an oblique osteotomy, shifted it again and pinned it and removed the overhang of bone. Closed the capsule with Vicryl, and closed the skin with interrupted Nylon, infiltration of Marcaine, Adaptic and Betadine and a compressive dressing applied.
Postoperative Plan: The plan is to have the patient weightbearing foot flat, dressings off in 3 days. Followup in the office in 10 to 14 days.