EricaWildinger
Contributor
I am really stumped on this. When I get the hospital face sheet and op report, the doctor puts his codes on there. I go through the op report and make sure he states what he coded (which he doesn't understand why, if he gives me the codes, what's the problem)...I have one op report here that doesn't jive to me with the codes he selected. I would really appreciate anybody's insight into this as I am still learning...a lot. He selected code 22327-Open treatment and/or reduction of vertebral fracture, posterior, 1 vertebra and a 22328- additional vertebra. The op report reads;
"After landmarks were drawn on the skin, the skin was carefully prepped and draped inthe usual sterile fashion, and gross focal localization was performed in order to gain ccess to the pedicles of T6, T7, T9, and T10 untilizing Jamshidi needle. Using percutaneous access, and fluoroscopic visualization, the pedicles were carefully cannulated utilizing 13 guage Jamshidi needles, and once the needles were in place through the pedicles into the vertebral body, a total of 2 mL of excellent bone marrow was aspirated from the pedicles. I wsas able to mix this with a total of 10 mL Healos FX morselized allograft for the bone fusion. After this was performed, the Jamshidi needles wer exchanged for skinny guidewires and utilizing a percutaneous fusion approach to the posterior elements of T6,
T7, T8, T9, and T, the bone of gthe posterior elements of these levels was carefully decorticated utilizing a 2 mm matchstick burr. The local shaving from this area were carefully harvested, and added to the abovementioned graft that was prepared already and together, this was placed over the posterolateral decorticated elements from T6-T10. Subsequently, the guidewires were carefully utilized for a tap to get into the pedicles and create screw heads, and subsequently, appropriately sized screws were placed over the guidewire into the pedicles without any difficulty. "
This doesn't sound like a 22327 to me. He does it all percutaneously, no incision was mentioned. Can someone please help? If this is indeed a 22327, can you explain how it is? I'm just trying to understand.
In case you need to know, the pt fell of some scaffolding and fractured T7 and T8..
"After landmarks were drawn on the skin, the skin was carefully prepped and draped inthe usual sterile fashion, and gross focal localization was performed in order to gain ccess to the pedicles of T6, T7, T9, and T10 untilizing Jamshidi needle. Using percutaneous access, and fluoroscopic visualization, the pedicles were carefully cannulated utilizing 13 guage Jamshidi needles, and once the needles were in place through the pedicles into the vertebral body, a total of 2 mL of excellent bone marrow was aspirated from the pedicles. I wsas able to mix this with a total of 10 mL Healos FX morselized allograft for the bone fusion. After this was performed, the Jamshidi needles wer exchanged for skinny guidewires and utilizing a percutaneous fusion approach to the posterior elements of T6,
T7, T8, T9, and T, the bone of gthe posterior elements of these levels was carefully decorticated utilizing a 2 mm matchstick burr. The local shaving from this area were carefully harvested, and added to the abovementioned graft that was prepared already and together, this was placed over the posterolateral decorticated elements from T6-T10. Subsequently, the guidewires were carefully utilized for a tap to get into the pedicles and create screw heads, and subsequently, appropriately sized screws were placed over the guidewire into the pedicles without any difficulty. "
This doesn't sound like a 22327 to me. He does it all percutaneously, no incision was mentioned. Can someone please help? If this is indeed a 22327, can you explain how it is? I'm just trying to understand.
In case you need to know, the pt fell of some scaffolding and fractured T7 and T8..