Closure of finger amputation

bwerner

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A little boy slammed his finger in a metal door and the distal portion of his right third finger was amputated.

My surgeon went over to the ER and the distal phalanx (which was exposed) was trimmed back with the use of a small ronger until it could be covered readily with soft tissue and then sutured closed.

I'm not sure what to use for this. The debridment codes or repair integ codes or something in the musculo section. Any suggestions would be great. I am going in circles.:rolleyes:
 

mkj2486

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I wound think you'd need to use a wound closure code. Amputation was done by the door not the doc, the way it sounds. So the doc closed the wound. You'll just have to figure out what type of closure, and the size of the wound. At least, that's my two cents.
 

bwerner

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The report says nothing about open fracture. It states that two of the sutures were placed through the distal remaining nail. A total of four sutures were used to close the tip. It seems pretty uncomplicated, just grinding the bone down enough to close the tip of the finger. For wound closure would you use intermediate or complex? I have no measurements, so maybe 12031?
 

heathermc

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With there being debridement of bone, I would use a complex, but if there were only 4 sutures, I would say it is less than 1 cm and the cpt tells you to use intermediate for that size (12041). If your doc will add an addendum to the report (if it was more than 1 cm) stating the size of repair, then I would use the complex (13131).
 

mbort

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If he indeed had to "grind" some of the bone (or remove it) as you mentioned, then that qualifies for the use of the 26951 and is more than just a complex closure of skin with debridement.
 
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