Incision and drainage status post shoulder arthroplasty

BNB0810

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I have code 23044 for this but feel like i am missing something. Please help!

status post right reverse total shoulder arthroplasty
Incision and drainage

specimens: 5 cultures taken from 5 locations plus another for pathology. Scar and amyloid appearing tissue.

Patient status post right reverse total shoulder arthroplasty. a month ago developed a cyst appearing structure. Had aspiration done and came back positive for alpha defensin test.The cyst ruptured and started draining.

Operative:
Prior incision opened and entire sinus tract was excised. it had fatty amyloid appearing tissue. I opened the deltopectoral interval. There was a lot of scar and more amyloid type tissue in the bursa. The first specimen was taken from the sinus tract. and went through the deltoid. Three specimens taken from the bursal area. which were continuous with the sinus tract and continuous with the joint. The fifth specimen taken from the glenosphere and humeral tray . And also a sample from glenosphere sent for pathology. Most of the scar and amyloid tissue was excised. the implants palpated and firmly intact. Wound was irigated, saline, bacitracin, pulse lavage. Hemovac drain was placed. ...
 

BNB0810

Contributor
Messages
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I just spoke to our orthopedic doctor and rejected this code she said that she did a extensive debridement of a infected joint prosthesis.
 
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I have code 23044 for this but feel like i am missing something. Please help!

status post right reverse total shoulder arthroplasty
Incision and drainage

specimens: 5 cultures taken from 5 locations plus another for pathology. Scar and amyloid appearing tissue.

Patient status post right reverse total shoulder arthroplasty. a month ago developed a cyst appearing structure. Had aspiration done and came back positive for alpha defensin test.The cyst ruptured and started draining.

Operative:
Prior incision opened and entire sinus tract was excised. it had fatty amyloid appearing tissue. I opened the deltopectoral interval. There was a lot of scar and more amyloid type tissue in the bursa. The first specimen was taken from the sinus tract. and went through the deltoid. Three specimens taken from the bursal area. which were continuous with the sinus tract and continuous with the joint. The fifth specimen taken from the glenosphere and humeral tray . And also a sample from glenosphere sent for pathology. Most of the scar and amyloid tissue was excised. the implants palpated and firmly intact. Wound was irigated, saline, bacitracin, pulse lavage. Hemovac drain was placed. ...
Possibly 23040 - Arthrotomy glenohumeral joint including exploration, drainage or removal of FB
 
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