Wiki Hand/finger coding

doodiebuggy

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Oshkosh, WI
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I need help with this one: Procedure performed - excision of recurrent mucous cyst right middle finger, arthrotomy and osteophyte excision from distal phalanx, full thickness skin graft from hypothenar eminence to distal phalanx of middle finger.

After anesthesia, circumferentially excised mass and took a small elliptical petal of skin along with mass in question, removing it while still preserving distal most portion of the nail fold, nail bed and terminal matrix tissue. Once removed we carried out 2 incisions proximally and lifted up full thickness skin proximal to excision area exposing extensor mechanism. Then did small arthrotomy from radial side, elevated extensor tendon and used rongeur to remove bony osteophytes at base of distal phalanx. We then thoroughly irrigated and obtained hemostasis, closed flap and harvested small matching skin graft from hypothenar eminence through separate small incision. Undermined this and closed donor site, took graft and inset in the defect area created by earlier excision. Attached graft and held in place with 5-0 chromic. Then applied compressive dressing over graft to provide compression and applied a similar dressing to the donor site.

Can someone please help me out with the codes on this one - i am new to fingers and under pressure.

Thanks
 
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