fish4codes
Networker
I would greatly appreciate help with references for the following operative scenario. I have been given codes, 26160 and 26110 (these bundle), I find references that suggest use of 26160 (excision of cyst off tendon sheath) and 26236 (osteophyte removal).
For the operative case below would it be considered over-coding to code: 26235, f7; 26236, 51, f7; 26160, 59, 51,f7
I have researched myself to the point of total confusion - thank you to those more experienced than me and taking time to help a fellow coder out !!
TECHNIQUE:
Patient was taken to the operating suite and after the induction of adequate general anesthetic the right upper extremity was prepped and draped in the usual sterile fashion. An Esmarch was used to exsanguinate the limb and the tourniquet was inflated to 250 mmHg. At this point in time an L shaped incision was made over the distal aspect of the right long finger have a large 1.5 x 1.5 cm lesion consistent with probable mucoid cyst. A radially based flap was elevated and dissection was carried down to the extensor sheath. There was a complex multi lobulated cystic lesion that was carefully excised off the extensor insertion and distal interphalangeal joint capsule radially. This was sent for pathologic identification. We carefully retracted the extensor mechanism and perform a distal interphalangeal joint arthrotomy with debridement of large dorsal osteophytes of both the base of the distal phalanx and the head of the middle phalanx. This was all sent for pathologic confirmation. The wound was then thoroughly irrigated. It was loosely closed with 4-0 nylon. Xeroform, 4 x 4's, and a compression wrap was applied to the right long finger. The patient tolerated this procedure well and went to recovery room in stable.
For the operative case below would it be considered over-coding to code: 26235, f7; 26236, 51, f7; 26160, 59, 51,f7
I have researched myself to the point of total confusion - thank you to those more experienced than me and taking time to help a fellow coder out !!
TECHNIQUE:
Patient was taken to the operating suite and after the induction of adequate general anesthetic the right upper extremity was prepped and draped in the usual sterile fashion. An Esmarch was used to exsanguinate the limb and the tourniquet was inflated to 250 mmHg. At this point in time an L shaped incision was made over the distal aspect of the right long finger have a large 1.5 x 1.5 cm lesion consistent with probable mucoid cyst. A radially based flap was elevated and dissection was carried down to the extensor sheath. There was a complex multi lobulated cystic lesion that was carefully excised off the extensor insertion and distal interphalangeal joint capsule radially. This was sent for pathologic identification. We carefully retracted the extensor mechanism and perform a distal interphalangeal joint arthrotomy with debridement of large dorsal osteophytes of both the base of the distal phalanx and the head of the middle phalanx. This was all sent for pathologic confirmation. The wound was then thoroughly irrigated. It was loosely closed with 4-0 nylon. Xeroform, 4 x 4's, and a compression wrap was applied to the right long finger. The patient tolerated this procedure well and went to recovery room in stable.