dsibley67
Networker
I have this so many times that I have confused myself!! I am trying to figure out if I need to code this as a bunion or just an osteotomy? I am thinking 28298 but I am not sure. Any help will be greatly appreciated.
POSTOPERATIVE DIAGNOSES: Mild hallux valgus right
PROCEDURES PERFORMED:
Akin osteotomy proximal phalanx right hallux with medial capsulorrhaphy. Modified McBride with
capsulorrhaphy
The patient was identified and placed on the treatment table in the supine
position. Prior cicatrix status is dorsal aspect of the first MTP following scrub, prep and drape in usual
normal aseptic manner. Right cicatrix was excised. After ankle tourniquet inflation, a linear periosteal
incision was made down to the joint of the first MTP. We did release the little capsule and a scar tissue
around the joint replacement laterally to decompress the lateral portal. We also restructured the medial
capsule where we could do a medial capsulorrhaphy which was not performed yet, felt the necessity for
distal Akin at this time. We went proximal to the IPJ of the hallux where an Akin osteotomy was
completed and an 8 mm bone staple inserted with excellent correction noted. At this point, we irrigated
with normal sterile saline to the medial capsulorrhaphy with #2-0 FiberWire. The hallux was notably
straighter without complication. Loading kept the toe straight and we then irrigated and closed the capsule
with 2-0 Vicryl, 3-0 Vicryl in the subcu and 4-0 nylon.
POSTOPERATIVE DIAGNOSES: Mild hallux valgus right
PROCEDURES PERFORMED:
Akin osteotomy proximal phalanx right hallux with medial capsulorrhaphy. Modified McBride with
capsulorrhaphy
The patient was identified and placed on the treatment table in the supine
position. Prior cicatrix status is dorsal aspect of the first MTP following scrub, prep and drape in usual
normal aseptic manner. Right cicatrix was excised. After ankle tourniquet inflation, a linear periosteal
incision was made down to the joint of the first MTP. We did release the little capsule and a scar tissue
around the joint replacement laterally to decompress the lateral portal. We also restructured the medial
capsule where we could do a medial capsulorrhaphy which was not performed yet, felt the necessity for
distal Akin at this time. We went proximal to the IPJ of the hallux where an Akin osteotomy was
completed and an 8 mm bone staple inserted with excellent correction noted. At this point, we irrigated
with normal sterile saline to the medial capsulorrhaphy with #2-0 FiberWire. The hallux was notably
straighter without complication. Loading kept the toe straight and we then irrigated and closed the capsule
with 2-0 Vicryl, 3-0 Vicryl in the subcu and 4-0 nylon.