11012?
11760 x2 F1/F2
26952?
This one has me stumped and looking to how others would code.
Thank you
J,CCS,CPC
DIAGNOSIS:
1. Left index finger, long finger, ring finger complex lacerations
POSTOP DIAGNOSIS:
1. Left index/long/ring finger complex lacerations with open distal phalanx fractures, hyponychial and nailbed tissue loss.
PROCEDURE:
1. Wound exploration / debridement Left index finger, long finger, ring fingers- skin/nailbed/bone
2. Repair Left index and long fingers nail beds
3. Left index, long and ring finger hyponychial rotation flaps ( 4 cm sq total )
4. Left ring finger terminal amputation and nail bed ablation
ASSISTANT:
no orthopedic resident on site or service).
ANESTHESIA:
LMA.
TOURNIQUET TIME:
13 minutes.
BLOOD LOSS:
Minimal.
FLUIDS:
Per anesthesia record
OPERATIVE FINDINGS: complex 2-4 digit lac with ST loss/ moderate devitalized hyponychial and nailbed tissues ring>index>long. Non-viable ring distal flap with subtotal nailbed loss.
OPERATIVE SUMMARY IN DETAIL:
Following appropriate informed consent, patient identification, and operative limb, the patient was brought to the operating suite where smooth induction of LMA anesthesia was accomplished by Anesthesiology Service and the patient received broad-spectrum IV antibiotic prophylaxis. The Left upper extremity was prepped and draped in the usual sterile fashion. Time-out procedure performed. The limb was exsanguinated with an Esmarch bandage prior to tourniquet inflation to 275 mmHg. Radial based flaps in the hyponychiums incision of the index finger, long finger, ring fingers were carried out incorporating the traumatic lacerations with findings above. Sharp dissection was carried debriding nonviable tissues in the 2-4 fingertips. The fingertips were excised back to healthy margins and assessed for closure and viability with the tourniquet let down. The ring finger flap was nonviable and was debrided and repaired with after the phalangeal bone was rongeured back with a ulnar based flap. The index and long finger hyponychial flaps were viable and rotated to cover the resected bone and distal nailbed margins. The digits were viable and warm x 5. There was no undue bleeding. Hemostasis performed using electrocautery. The wounds were reapproximated with nonabsorbable sutures and infiltrated with 0.5% Marcaine for perioperative pain relief. Sterile nonadherent dressing and extension block splint was applied. The patient was extubated and transported to the recovery area in stable condition. There were no intraoperative complications.
11760 x2 F1/F2
26952?
This one has me stumped and looking to how others would code.
Thank you
J,CCS,CPC
DIAGNOSIS:
1. Left index finger, long finger, ring finger complex lacerations
POSTOP DIAGNOSIS:
1. Left index/long/ring finger complex lacerations with open distal phalanx fractures, hyponychial and nailbed tissue loss.
PROCEDURE:
1. Wound exploration / debridement Left index finger, long finger, ring fingers- skin/nailbed/bone
2. Repair Left index and long fingers nail beds
3. Left index, long and ring finger hyponychial rotation flaps ( 4 cm sq total )
4. Left ring finger terminal amputation and nail bed ablation
ASSISTANT:
no orthopedic resident on site or service).
ANESTHESIA:
LMA.
TOURNIQUET TIME:
13 minutes.
BLOOD LOSS:
Minimal.
FLUIDS:
Per anesthesia record
OPERATIVE FINDINGS: complex 2-4 digit lac with ST loss/ moderate devitalized hyponychial and nailbed tissues ring>index>long. Non-viable ring distal flap with subtotal nailbed loss.
OPERATIVE SUMMARY IN DETAIL:
Following appropriate informed consent, patient identification, and operative limb, the patient was brought to the operating suite where smooth induction of LMA anesthesia was accomplished by Anesthesiology Service and the patient received broad-spectrum IV antibiotic prophylaxis. The Left upper extremity was prepped and draped in the usual sterile fashion. Time-out procedure performed. The limb was exsanguinated with an Esmarch bandage prior to tourniquet inflation to 275 mmHg. Radial based flaps in the hyponychiums incision of the index finger, long finger, ring fingers were carried out incorporating the traumatic lacerations with findings above. Sharp dissection was carried debriding nonviable tissues in the 2-4 fingertips. The fingertips were excised back to healthy margins and assessed for closure and viability with the tourniquet let down. The ring finger flap was nonviable and was debrided and repaired with after the phalangeal bone was rongeured back with a ulnar based flap. The index and long finger hyponychial flaps were viable and rotated to cover the resected bone and distal nailbed margins. The digits were viable and warm x 5. There was no undue bleeding. Hemostasis performed using electrocautery. The wounds were reapproximated with nonabsorbable sutures and infiltrated with 0.5% Marcaine for perioperative pain relief. Sterile nonadherent dressing and extension block splint was applied. The patient was extubated and transported to the recovery area in stable condition. There were no intraoperative complications.