IRISHCODER
Networker
My surgeon dictated the following OP Report and provided a code, 28615, as he likes to code his procedures. I always read and either confirm or correct the codes. This time, I am not sure if he did ONLY this procedure because I believe I'm reading additional (or just different) procedure(s) being done. Any advice would be appreciated:
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Dissection was carried down to the bone. A reduction maneuver was performed and the medial and middle cuneiforms were reduced. Subsequently through a small percutaneous incision a 4.5 cannulated screw was passed from medial to lateral, from lateral securing the medial and middle cuneiform joint. Subsequently the second metatarsal base fracture was secured using a retrograde screw extending from the second metatarsal shaft into the middle cuneiform. This was performed with cannulated screw 3.0mm. Care was taken again to protect the neurovascular structures. Subsequently a screw was passed from the medial cuneiform into the base of the second metatarsal. This secured the Lisfranc joint as well as the medial and middle cuneiform joint as well as the base of the second metatarsal to the middle cuneiform.
Attention was turned then to the lesser metatarsals. Another dorsal longitudinal linear incision was made in between the third and fourth intermetatarsal space. Dissection was carried down to the bone. Neurovascular structions were again protected. A retrograde pin was passed both through the third and fouth metatarsal shafts and passed retrograde through the shaft and secured. This reduced the third and fourth metatarsal fractures. Subsequently a percutaneous pin was passed retrograde through the fifth metatarsal into the securing the reduction of the fifth tarsometatarsal dislocation.
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I believe I see 28485 and/or 28476 with perhaps the 28615 the doctor indicated. At this point I'm not sure what he did and where. Any suggestions?
Thanks!
***
Dissection was carried down to the bone. A reduction maneuver was performed and the medial and middle cuneiforms were reduced. Subsequently through a small percutaneous incision a 4.5 cannulated screw was passed from medial to lateral, from lateral securing the medial and middle cuneiform joint. Subsequently the second metatarsal base fracture was secured using a retrograde screw extending from the second metatarsal shaft into the middle cuneiform. This was performed with cannulated screw 3.0mm. Care was taken again to protect the neurovascular structures. Subsequently a screw was passed from the medial cuneiform into the base of the second metatarsal. This secured the Lisfranc joint as well as the medial and middle cuneiform joint as well as the base of the second metatarsal to the middle cuneiform.
Attention was turned then to the lesser metatarsals. Another dorsal longitudinal linear incision was made in between the third and fourth intermetatarsal space. Dissection was carried down to the bone. Neurovascular structions were again protected. A retrograde pin was passed both through the third and fouth metatarsal shafts and passed retrograde through the shaft and secured. This reduced the third and fourth metatarsal fractures. Subsequently a percutaneous pin was passed retrograde through the fifth metatarsal into the securing the reduction of the fifth tarsometatarsal dislocation.
***
I believe I see 28485 and/or 28476 with perhaps the 28615 the doctor indicated. At this point I'm not sure what he did and where. Any suggestions?
Thanks!
