abyrne
Networker
I just need a second opinion please. Provider wants to bill CPT 24101 & 24359. CCI edits do allow both (24101 with a 59), however I'm not sure both should be reported.
OP note says :
The right upper extremity was exsanguinated and tourniquet inflated to 250 mmHg. I made a longitudinal incision over the lateral aspect of the elbow, starting at the lateral epicondyle, coursing distal for about 5 cm. Full-thickness skin flaps were developed. Hemostasis was obtained with bipolar cautery. Dissection was carried down to the lateral epicondyle and the extensor origin. The ECRB tendon was identified and there was some edematous tendon that was debrided sharply. This was debrided back to a normal-appearing tendon. I also debrided the bone of the lateral epicondyle down to cancellous bone and stimulated bleeding. This was smoothed down with a rasp. I made a longitudinal arthrotomy in the lateral aspect of the elbow joint. The joint was explored and there was no articular damage or any signs of extensive synovitis. The joint and the wound were then copiously irrigated. I closed the deep joint capsule layer with #2 FiberWire. The superficial fascia layer was closed with 3-0 Ethibond. The subcutaneous tissue was closed with 3-0 Vicryl, and skin was closed with 4-0 nylon. The elbow was infiltrated with 10 mL of 0.5% Marcaine for postop pain control. Sterile dressing was placed. The tourniquet was released with brisk cap refill in all digits at the end of the case. Patient tolerated the procedure well, was extubated, and brought to recovery room in stable condition.
Any thoughts ??
OP note says :
The right upper extremity was exsanguinated and tourniquet inflated to 250 mmHg. I made a longitudinal incision over the lateral aspect of the elbow, starting at the lateral epicondyle, coursing distal for about 5 cm. Full-thickness skin flaps were developed. Hemostasis was obtained with bipolar cautery. Dissection was carried down to the lateral epicondyle and the extensor origin. The ECRB tendon was identified and there was some edematous tendon that was debrided sharply. This was debrided back to a normal-appearing tendon. I also debrided the bone of the lateral epicondyle down to cancellous bone and stimulated bleeding. This was smoothed down with a rasp. I made a longitudinal arthrotomy in the lateral aspect of the elbow joint. The joint was explored and there was no articular damage or any signs of extensive synovitis. The joint and the wound were then copiously irrigated. I closed the deep joint capsule layer with #2 FiberWire. The superficial fascia layer was closed with 3-0 Ethibond. The subcutaneous tissue was closed with 3-0 Vicryl, and skin was closed with 4-0 nylon. The elbow was infiltrated with 10 mL of 0.5% Marcaine for postop pain control. Sterile dressing was placed. The tourniquet was released with brisk cap refill in all digits at the end of the case. Patient tolerated the procedure well, was extubated, and brought to recovery room in stable condition.
Any thoughts ??