Ethanzoe
Contributor
Hello,
Provider amputated toe at MTP. I know the amputation code. Pre-Authed 14040 but decscribes in body of note fillet of toe flap. I am confused between the two. Can someone clearly explain the difference between the two. If I understand 14040 is incised from nearby tissue, rotated and sutured over defect. 14350 is not making clear sense to me?
Procedures:
* Surgical amputation right second metatarsal phalangeal joint
* ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10 SQ CM OR LESS
Post-op Diagnosis
* Hammertoe of second toe of right foot [M20.41]
Amputation right second toe with fillet of toe flap:
At this point attention was directed dorsal to the right second toe where 2 racquet shaped incisions were made around the base of the proximal phalanx of the second toe. Dissection carried into the skin and subcutaneous tissue being cared above retract and ligate any vessels do necessary to maintain adequate surgical hemostasis. This time resection full-thickness carried down to the metatarsal phalangeal joint. Metatarsal flan joint was disarticulated. The toe was sent for pathological examination. At this time the flaps on both margins of the second toe were advanced utilizing Metzenbaum scissors under minimal tension the incision was closed with nonabsorbable suture in alternating horizontal mattress simple interrupted suture. Incision came together with minimal tension. Xeroform was applied to the right foot with dry sterile dressing. Short leg Cam walker applied to the right leg as well. IntraOp fluoroscopy to confirm the resection of the articulation of the second toe at the MPJ level. This was confirmed. Patient was extubated successfully.
Provider amputated toe at MTP. I know the amputation code. Pre-Authed 14040 but decscribes in body of note fillet of toe flap. I am confused between the two. Can someone clearly explain the difference between the two. If I understand 14040 is incised from nearby tissue, rotated and sutured over defect. 14350 is not making clear sense to me?
Procedures:
* Surgical amputation right second metatarsal phalangeal joint
* ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10 SQ CM OR LESS
Post-op Diagnosis
* Hammertoe of second toe of right foot [M20.41]
Amputation right second toe with fillet of toe flap:
At this point attention was directed dorsal to the right second toe where 2 racquet shaped incisions were made around the base of the proximal phalanx of the second toe. Dissection carried into the skin and subcutaneous tissue being cared above retract and ligate any vessels do necessary to maintain adequate surgical hemostasis. This time resection full-thickness carried down to the metatarsal phalangeal joint. Metatarsal flan joint was disarticulated. The toe was sent for pathological examination. At this time the flaps on both margins of the second toe were advanced utilizing Metzenbaum scissors under minimal tension the incision was closed with nonabsorbable suture in alternating horizontal mattress simple interrupted suture. Incision came together with minimal tension. Xeroform was applied to the right foot with dry sterile dressing. Short leg Cam walker applied to the right leg as well. IntraOp fluoroscopy to confirm the resection of the articulation of the second toe at the MPJ level. This was confirmed. Patient was extubated successfully.