Irrigation and Debridement septic olecranon bursitis

jeskla

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Would someone please help me with this op note? The doc has irrigation and debridement as the procedure, but I am not seeing that in the body of the note. It looks like he just punctured the bursa with a needle and irrigated it. Would this just be 20605-LT since there was no incision? :confused:

ASSESSMENT
Left septic olecranon bursitis.

PLAN
Irrigation and debridement.

After consent was obtained and sterile prep, an 18-gauge needle was
introduced into the olecranon bursa. The olecranon bursa was then
insufflated with 10 mL of 1% lidocaine to effect local anesthesia. Following
this, the bursa was repeatedly irrigated with sterile saline, a total of 100
mL was irrigated sequentially in and out of joint in 20 mL aliquots. With
initial needle penetration, 3 mL of purulent fluid were sent for culture.

Once irrigation was complete, the needle was withdrawn. The patient
tolerated the procedure well with no complications.
 
Last edited:

mjfrog1

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Lima, Ohio
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The operative report makes no mention of debridement, so I would not code that. You can code 20605-LT since he/she did perform an aspiration(20605 mentions olecranon bursa--CPT 20610 does not).

Any thoughts?

Sue, CPC, CCS-P





Would someone please help me with this op note? The doc has irrigation and debridement as the procedure, but I am not seeing that in the body of the note. It looks like he just punctured the bursa with a needle and irrigated it. Would this just be 20610-LT since there was no incision? :confused:

ASSESSMENT
Left septic olecranon bursitis.

PLAN
Irrigation and debridement.

After consent was obtained and sterile prep, an 18-gauge needle was
introduced into the olecranon bursa. The olecranon bursa was then
insufflated with 10 mL of 1% lidocaine to effect local anesthesia. Following
this, the bursa was repeatedly irrigated with sterile saline, a total of 100
mL was irrigated sequentially in and out of joint in 20 mL aliquots. With
initial needle penetration, 3 mL of purulent fluid were sent for culture.

Once irrigation was complete, the needle was withdrawn. The patient
tolerated the procedure well with no complications.
 

jeskla

Networker
Messages
63
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Yes, all I can see is the 20605 also. Thank you for your help.
 
Last edited:
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