Justarose
Guest
Been toiling over this all day yesterday ( well, not all day ! but long enough ...) I really could use some help/advice...thanks!
POSTOPERATIVE DIAGNOSIS: Right index finger nailbed deformity with retained foreign material, germinal matrix. .
PROCEDURE PERFORMED: Excision of sterile and germinal matrix scar, removal of foreign material, right index finger nailbed.
Consent was obtained. The patient was taken to the operating room and was given a general anesthetic at her request. The right upper extremity was then sterilely prepped and draped in a normal fashion with DuraPrep. The digit was blocked with 0.5% Marcaine for postoperative pain control. The digit was blocked with 0.5% Marcaine for postoperative pain control. The nail plate was then removed. Eponychial incisions were made elevating the proximal eponychial fold. At this point, the scar in the germinal matrix was excised along the course of the cicatrix. Once completely excised, this exposed the retained metallic fragments underneath the germinal matrix and embedded into the dorsal aspect of the distal phalanx. This was copiously irrigated with pulse lavage and then sharp dissection under loupe magnification with a scalpel and Beaver blade to remove the retained material. Once completely removed, the wounds were irrigated. We were able to approximate the germinal matrix with a 6-0 plain gut suture and then a Xeroform gauze was applied over the top of the nail bed and then the eponychium repaired with 6-0 plain gut suture. Dry dressing was applied. The tourniquet was removed. The patient was transferred to the recovery room in stable condition.
This is what I have so far : 13100 F6 for the removal of foreign material nailbed - ???
but stuck on : Excision of matrix scar : could this be right ?
11760 ?
I don't really think so ; doc wants to bill w/11762 but I don't see a graft anywhere
How about diagnosis for disformity ?
Thank you so much !!
POSTOPERATIVE DIAGNOSIS: Right index finger nailbed deformity with retained foreign material, germinal matrix. .
PROCEDURE PERFORMED: Excision of sterile and germinal matrix scar, removal of foreign material, right index finger nailbed.
Consent was obtained. The patient was taken to the operating room and was given a general anesthetic at her request. The right upper extremity was then sterilely prepped and draped in a normal fashion with DuraPrep. The digit was blocked with 0.5% Marcaine for postoperative pain control. The digit was blocked with 0.5% Marcaine for postoperative pain control. The nail plate was then removed. Eponychial incisions were made elevating the proximal eponychial fold. At this point, the scar in the germinal matrix was excised along the course of the cicatrix. Once completely excised, this exposed the retained metallic fragments underneath the germinal matrix and embedded into the dorsal aspect of the distal phalanx. This was copiously irrigated with pulse lavage and then sharp dissection under loupe magnification with a scalpel and Beaver blade to remove the retained material. Once completely removed, the wounds were irrigated. We were able to approximate the germinal matrix with a 6-0 plain gut suture and then a Xeroform gauze was applied over the top of the nail bed and then the eponychium repaired with 6-0 plain gut suture. Dry dressing was applied. The tourniquet was removed. The patient was transferred to the recovery room in stable condition.
This is what I have so far : 13100 F6 for the removal of foreign material nailbed - ???
but stuck on : Excision of matrix scar : could this be right ?
11760 ?
I don't really think so ; doc wants to bill w/11762 but I don't see a graft anywhere
How about diagnosis for disformity ?
Thank you so much !!