kimmcelderry@gmail.com
Networker
- Messages
- 59
- Location
- Mobile, AL
There is a lot of confusion around whether to code this as 26480 or 25310. The intra-service description for both look the same and diagrams are not helpful. The other hand coders and I keep going back and forth and cannot reach a definitive answer. Any advice or guidance?
Typical op note snippet we're seeing for this procedure:
"We began with a transverse incision at the MP joint of the index finger. The 2 tendons were identified and separated. The ulnar deeper tendon was identified. The patient demonstrated independent use of this tendon and it was tenotomized. We then through the incision dissected it and freed it up from the adjacent EDC tendon
We then open the scar for her wrist fusion over the wrist. We dissected down through the scarred area. We identified the tendons. Again using active motion of the tendon and passive traction on the tendon we identified it proximally. It required a moderate amount of tenolysis but it was released and brought into the proximal incision. That tendon was held in a moist sponge and then an incision over the dorsal radial wrist and thumb metacarpal was performed. Dissection was carried down protecting cutaneous nerves. The EPL tendon was identified. It was mobilized and released from pseudo tendon proximally
We then dissected a subcutaneous tunnel between the wrist incision and the thumb incision and a tendon passer brought the tendon freely through that area. The 2 tendons were approximated in a snug position and held with 1 figure-of-eight 3-0 Ethibond suture. At this point the patient was asked to demonstrate retropulsion of the thumb and she was able to do so. We adjusted the tension and then did a side-to-side tendon transfer with 3-0 Ethibond suture. The patient was then asked to demonstrate and index extension with good retropulsion and extension of the thumb noted"
Typical op note snippet we're seeing for this procedure:
"We began with a transverse incision at the MP joint of the index finger. The 2 tendons were identified and separated. The ulnar deeper tendon was identified. The patient demonstrated independent use of this tendon and it was tenotomized. We then through the incision dissected it and freed it up from the adjacent EDC tendon
We then open the scar for her wrist fusion over the wrist. We dissected down through the scarred area. We identified the tendons. Again using active motion of the tendon and passive traction on the tendon we identified it proximally. It required a moderate amount of tenolysis but it was released and brought into the proximal incision. That tendon was held in a moist sponge and then an incision over the dorsal radial wrist and thumb metacarpal was performed. Dissection was carried down protecting cutaneous nerves. The EPL tendon was identified. It was mobilized and released from pseudo tendon proximally
We then dissected a subcutaneous tunnel between the wrist incision and the thumb incision and a tendon passer brought the tendon freely through that area. The 2 tendons were approximated in a snug position and held with 1 figure-of-eight 3-0 Ethibond suture. At this point the patient was asked to demonstrate retropulsion of the thumb and she was able to do so. We adjusted the tension and then did a side-to-side tendon transfer with 3-0 Ethibond suture. The patient was then asked to demonstrate and index extension with good retropulsion and extension of the thumb noted"