KristinM522
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Can anyone tell me how they would code the procedure below? I don't do many hemi's to TSA's and I can only find advice from prior to the revision TSA codes coming out. I think I am just confusing myself more. Thank you in advance!!
Pre-operative Diagnosis:
Mechanical complication of internal orthopedic graft
After achieving a suitable level of anesthesia using a general anesthetic patient was positioned on the Arthrex positioner so that suitable approach to the left shoulder could be obtained. Using the prior incision the subcutaneous layers were dissected sharply down to the anterior capsular structures. Upon entering the capsule cultures were taken we open the capsule to deliver the CTA head and further cultures were taken throughout both tissue and routine cultures for anaerobic and aerobic growth to be held for 10 to 14 days postoperatively. There was no suspicion of infection from the visual approach at this point in time. CTA head was removed and the canal was then prepared for a Tornier/right medical reverse stem. The trial broach was then introduced to protect the proximal humeral structures and the glenoid was then exposed. Excellent bone structure was remaining here in the glenoid and it was then prepared for the standard baseplate and 2 locking and 1 nonlocking screw along with the central screw was introduced after this was prepped. A 36 mm offset head was then chosen and the glenosphere was implanted. Attention was drawn to the humeral side and a standard stem with a 30 mm body and a 6 mm bearing insert was then trialed and reduction revealed excellent range of motion. The permanent implants were then seated in place. Prior to doing this multiple sutures and anchors were identified and they were removed in their entirety. The permanent mint implants were then placed reduction was achieved excellent range of motion stability was achieved at this point in time. Throughout the case there was copious jet lavage and antibiotic irrigation. IV antibiotics were started after the last culture was taken. The wound was then closed with #2 max braid type sutures in the deep layers Vicryl and subcu use Biosyn subcuticular stitch and a Hemovac drain was placed deep in the wound. Patient tolerated suture well was turned to PAR in stable condition.
Pre-operative Diagnosis:
Mechanical complication of internal orthopedic graft
After achieving a suitable level of anesthesia using a general anesthetic patient was positioned on the Arthrex positioner so that suitable approach to the left shoulder could be obtained. Using the prior incision the subcutaneous layers were dissected sharply down to the anterior capsular structures. Upon entering the capsule cultures were taken we open the capsule to deliver the CTA head and further cultures were taken throughout both tissue and routine cultures for anaerobic and aerobic growth to be held for 10 to 14 days postoperatively. There was no suspicion of infection from the visual approach at this point in time. CTA head was removed and the canal was then prepared for a Tornier/right medical reverse stem. The trial broach was then introduced to protect the proximal humeral structures and the glenoid was then exposed. Excellent bone structure was remaining here in the glenoid and it was then prepared for the standard baseplate and 2 locking and 1 nonlocking screw along with the central screw was introduced after this was prepped. A 36 mm offset head was then chosen and the glenosphere was implanted. Attention was drawn to the humeral side and a standard stem with a 30 mm body and a 6 mm bearing insert was then trialed and reduction revealed excellent range of motion. The permanent implants were then seated in place. Prior to doing this multiple sutures and anchors were identified and they were removed in their entirety. The permanent mint implants were then placed reduction was achieved excellent range of motion stability was achieved at this point in time. Throughout the case there was copious jet lavage and antibiotic irrigation. IV antibiotics were started after the last culture was taken. The wound was then closed with #2 max braid type sutures in the deep layers Vicryl and subcu use Biosyn subcuticular stitch and a Hemovac drain was placed deep in the wound. Patient tolerated suture well was turned to PAR in stable condition.