My orthopaedic surgeon performed on the left foot the following:
1. Posterior tibialis tendon debridement and FDL transfer to navicular bone (27691).
2. Spring ligament reconstruction with InternalBrace (28899, compare to 27698).
3. Medializing calcaneal osteotomy - I'm not sure if 28300 is considered correct for the below-described procedural detail, or if this would code to unlisted 28899, compare to 28300. CDR for 28300 appears to describe an open approach (i.e., exposure/retraction of nerve, stripping of peroneal sheath) only.
Thoughts?
"With her foot held in a corrected position, she had adequate dorsiflexion; therefore, gastroc recession was not needed. I proceeded forward with the calcaneal osteotomy. A small 1 cm incision was made over the lateral side of her heel. Blunt dissection is taken down to the periosteum. The periosteum was elevated dorsally and plantarly. With live fluoroscopic view, a Shannon burr was used to perform a percutaneous osteotomy cut obliquely through the calcaneal tuberosity. Once complete, the posterior portion of this was translated medially about 5 mm and fixed in place with a percutaneously placed headless compression screw across the osteotomy. Fluoroscopy confirmed appropriate alignment through the osteotomy and screw placement."
Thank you.
1. Posterior tibialis tendon debridement and FDL transfer to navicular bone (27691).
2. Spring ligament reconstruction with InternalBrace (28899, compare to 27698).
3. Medializing calcaneal osteotomy - I'm not sure if 28300 is considered correct for the below-described procedural detail, or if this would code to unlisted 28899, compare to 28300. CDR for 28300 appears to describe an open approach (i.e., exposure/retraction of nerve, stripping of peroneal sheath) only.
Thoughts?
"With her foot held in a corrected position, she had adequate dorsiflexion; therefore, gastroc recession was not needed. I proceeded forward with the calcaneal osteotomy. A small 1 cm incision was made over the lateral side of her heel. Blunt dissection is taken down to the periosteum. The periosteum was elevated dorsally and plantarly. With live fluoroscopic view, a Shannon burr was used to perform a percutaneous osteotomy cut obliquely through the calcaneal tuberosity. Once complete, the posterior portion of this was translated medially about 5 mm and fixed in place with a percutaneously placed headless compression screw across the osteotomy. Fluoroscopy confirmed appropriate alignment through the osteotomy and screw placement."
Thank you.