Hematoma and Distraction Arthroplasty left thumb

jeskla

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Hi everyone,
I'm still a newbie at surgery coding, and was hoping someone could help me with this one. In the op note, the doctor says he does a left thumb arthroplasty using the mini tightrope procedure for distraction arthroplasty. When I first saw the diagnosis of pantrapezial OA, I immediately thought it was going to be a 25447 Arthroplasty, interposition, intercarpal or carpometacarpal joints. However, it doesn't look like he interposes any ligaments/tendons...but he does use an Arthrex Tightrope he leaves in place. Is this still considered 25447?

"Open approach...skeletonized trapezius...using Mini tightrope we placed the pin supplied by Arthrex through the base of the thumb metacarpal and in through the metadiaphyseal flare of the index finger metacarpal. We then delivered the mini tightrope through the pin with the loop in it and did one single knot holding the palm in full abduction to prevent over tightening. We placed the hemostat. We then addressed out attention to the trapezius where we placed the corkscrew and removed the trapezius en toto.We then finished securing the tightrope with multiple half hitches. We then buries the knot with a free needle underneath the interossei of the index finger.
 

jeskla

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I guess I'm going to try to bill it as 25447 with the logic that the arthrex tightrope system was used as the interposition...will try to let you know how if the insurance company denies it.
 
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