- Messages
- 2
- Best answers
- 0
Hello, i need help on an encounter note. I’m reviewing a procedure where the provider opened a surgical scar and explored the area, but nothing significant was found. The current code used was 28080 (Excision, interdigital (Morton) neuroma, single, each), but it seems like this might not be appropriate since there was no pathology removed or addressed.
If we don’t have a code to directly support this service (since nothing was found), what steps would i need to take to handle this claim? Would we consider not billing for this, or should we look into using an unlisted procedure code or another option? Let me know your thoughts on how i should proceed here.
this is his procedure note: Pt. ambulated into the operating room and was placed in the supine position. 5 CC of 0.5% marcaine plain was instilled dorsal 5th met head. The foot scrubbed preped and draped. 2 semi elliptical skin excisions were performed down to capsule. The area was inspected for any remnants of scar and none were found. The deep structures were closed with simple sutures of 3-0 vicryl, the subcutaneous tissues were closed with running sutures of 4-0 vicryl, and the skin incision was closed with running subcuticular sutures of 4-0 nylon. The wound was dressed with steri-strips. 0.5 cc of celestone was instilled into the wound. The foot was covered with 4X4's in a compression dressing. The tourniquet was then deflated and the immediate vascular response of all digits was then noted."
Thanks
If we don’t have a code to directly support this service (since nothing was found), what steps would i need to take to handle this claim? Would we consider not billing for this, or should we look into using an unlisted procedure code or another option? Let me know your thoughts on how i should proceed here.
this is his procedure note: Pt. ambulated into the operating room and was placed in the supine position. 5 CC of 0.5% marcaine plain was instilled dorsal 5th met head. The foot scrubbed preped and draped. 2 semi elliptical skin excisions were performed down to capsule. The area was inspected for any remnants of scar and none were found. The deep structures were closed with simple sutures of 3-0 vicryl, the subcutaneous tissues were closed with running sutures of 4-0 vicryl, and the skin incision was closed with running subcuticular sutures of 4-0 nylon. The wound was dressed with steri-strips. 0.5 cc of celestone was instilled into the wound. The foot was covered with 4X4's in a compression dressing. The tourniquet was then deflated and the immediate vascular response of all digits was then noted."
Thanks