I can't seem to find an appropriate cpt code for an extensor tendon debridement of the wrist. An excision of a carpal boss was also performed. My physician thinks 25000 is the best code but I think there is a better code. The op report is below. Thank you for your help!
After informed consent was obtained, the patient was brought to the operating
room, placed in the supine position. A general anesthetic was administered
by the Anesthesia Department and a sterile tourniquet was placed on the right
upper arm and the right upper extremity was then prepped and draped in the
usual sterile fashion. A procedural pause was carried out to verify the
patient's identity as well as the site and side of the procedure to be
performed. An Esmarch was applied to the limb; the tourniquet was inflated
to 250 mmHg. An incision was made longitudinally over the palpable bony
overgrowth at the extensor, carpi, radialis, brevis and longus insertion.
Dissection was carried down to the subcutaneous tissue. Bipolar
Cautery was used for hemostasis. The extensor tendons were identified at the
2nd and 3rd metacarpal bases. The bony overgrowth was removed with an
osteotome and a mallet as well as with a rongeur. Smooth-surfaced bone was
left in place. The extensor tendons were left attached to the bone but
debrided. No residual palpable abnormality was present. The abnormal bony
overgrowth that was debrided was sent to Pathology for evaluation. AP
lateral images were taken, saved and printed. The wound was copiously
irrigated and closed with interrupted 4-0 Prolene suture. A sterile dressing
was placed and the patient was placed in a volar splint. The tourniquet was
then deflated. Brisk capillary refill returned to the tips of the digits.
The patient was then awoken from anesthesia and transported to the recovery
room in satisfactory condition without complication.
After informed consent was obtained, the patient was brought to the operating
room, placed in the supine position. A general anesthetic was administered
by the Anesthesia Department and a sterile tourniquet was placed on the right
upper arm and the right upper extremity was then prepped and draped in the
usual sterile fashion. A procedural pause was carried out to verify the
patient's identity as well as the site and side of the procedure to be
performed. An Esmarch was applied to the limb; the tourniquet was inflated
to 250 mmHg. An incision was made longitudinally over the palpable bony
overgrowth at the extensor, carpi, radialis, brevis and longus insertion.
Dissection was carried down to the subcutaneous tissue. Bipolar
Cautery was used for hemostasis. The extensor tendons were identified at the
2nd and 3rd metacarpal bases. The bony overgrowth was removed with an
osteotome and a mallet as well as with a rongeur. Smooth-surfaced bone was
left in place. The extensor tendons were left attached to the bone but
debrided. No residual palpable abnormality was present. The abnormal bony
overgrowth that was debrided was sent to Pathology for evaluation. AP
lateral images were taken, saved and printed. The wound was copiously
irrigated and closed with interrupted 4-0 Prolene suture. A sterile dressing
was placed and the patient was placed in a volar splint. The tourniquet was
then deflated. Brisk capillary refill returned to the tips of the digits.
The patient was then awoken from anesthesia and transported to the recovery
room in satisfactory condition without complication.