Can someone please help me make sure that I coded this correctly? I used 20690 for the left middle finger and 26725 for the left ring finger. I was told that this was not correct. If it is not correct can you please help me understand why? Thanks in advance for your help!
POSTOPERATIVE DIAGNOSES: Left middle finger base of the middle phalanx
fracture, left ring finger base of the middle
phalanx fracture.
PROCEDURES PERFORMED: 1. Dynamic external fixator left middle finger
base of the middle phalanx fracture.
2. Closed reduction left ring finger base of the
middle phalanx fracture
DESCRIPTION OF PROCEDURE: The patient was seen preoperatively, site was marked and
verified. Preoperative antibiotics had been given. She was taken back to the OR. Time-out was taken at
the beginning of the procedure. A local block was performed at the base of the left middle and ring finger.
We began by evaluating the fractures under C-arm. We manipulated the ring finger to improve her slight
ulnar deviation. The joint otherwise appeared adequately aligned. The middle finger was more displaced,
elected to proceed with a dynamic external fixator for this fracture, but felt like adding fixation to the ring
finger would be detrimental. At this point, we then established the guidepin across the proximal phalanx
head, size 0.045. Once we verified adequate position of this first K-wire, a second 0.045 K-wire was
placed transversely across the middle phalanx. We verified adequate position of these wires and then
subsequently bent the wires in a fashion similar to a Slade dynamic external fixator. Once the wires were
bent appropriately, then rubber bands were used for dressing. We then verified adequate alignment of the
fracture. We took the finger through range of motion and noted that we were able to get full extension
and approximately 90 degrees of flexion on the PIP joint. Sterile dressings were applied. She tolerated
the procedure well and was placed in a finger splint for both the middle and ring finger.
POSTOPERATIVE DIAGNOSES: Left middle finger base of the middle phalanx
fracture, left ring finger base of the middle
phalanx fracture.
PROCEDURES PERFORMED: 1. Dynamic external fixator left middle finger
base of the middle phalanx fracture.
2. Closed reduction left ring finger base of the
middle phalanx fracture
DESCRIPTION OF PROCEDURE: The patient was seen preoperatively, site was marked and
verified. Preoperative antibiotics had been given. She was taken back to the OR. Time-out was taken at
the beginning of the procedure. A local block was performed at the base of the left middle and ring finger.
We began by evaluating the fractures under C-arm. We manipulated the ring finger to improve her slight
ulnar deviation. The joint otherwise appeared adequately aligned. The middle finger was more displaced,
elected to proceed with a dynamic external fixator for this fracture, but felt like adding fixation to the ring
finger would be detrimental. At this point, we then established the guidepin across the proximal phalanx
head, size 0.045. Once we verified adequate position of this first K-wire, a second 0.045 K-wire was
placed transversely across the middle phalanx. We verified adequate position of these wires and then
subsequently bent the wires in a fashion similar to a Slade dynamic external fixator. Once the wires were
bent appropriately, then rubber bands were used for dressing. We then verified adequate alignment of the
fracture. We took the finger through range of motion and noted that we were able to get full extension
and approximately 90 degrees of flexion on the PIP joint. Sterile dressings were applied. She tolerated
the procedure well and was placed in a finger splint for both the middle and ring finger.