I have literally been working on this for hours! I think at this point I'm overthinking it. I could really use some help
The fingernail was then carefully removed from the left thumb and nail. Two oblique incisions were made into the nail fold to reflect the skin over the germinal matrix. There was a bony abnormality and deformity of the germinal matrix with some partial-thickness loss and scar over the sterile matrix. The scarred areas were then excised completely. The bone was then trimmed back towards smooth surface. The germinal matrix was then able to be repaired and did not require full-thickness grafting, but this was able to be advanced in and smoothed out; however, about 8-mm wide section of the sterile matrix required debridement and partial-thickness grafting for the appropriate contours
The left second toenail was removed and using a template, a split-thickness nail bed graft was then harvested from the left second toe. The toenails were placed and secured with 5-0 chromic sutures. The split nail graft was then trimmed to fit the defect and inset with interrupted 5-0 chromic sutures as well as the repair of the germinal matrix. Next, a foil from the suture pack was then cut into a nail shape and placed into the nail fold to stent this open. The nail fold incisions were closed with interrupted 5-0 chromic as well as suturing down the artificial nail from the foil pack.
I'm thinking 11762 and 15050. I could really be wrong on the 15050 but it isn't a big area to cover and I'm wondering if I'm missing the nail removal on the second toe. Should I also code for the bone aspect?
Any help is greatly appreciated because I'm on my last patch of hair on my head. I'm about to pull that out as well. Have a great weekend.
The fingernail was then carefully removed from the left thumb and nail. Two oblique incisions were made into the nail fold to reflect the skin over the germinal matrix. There was a bony abnormality and deformity of the germinal matrix with some partial-thickness loss and scar over the sterile matrix. The scarred areas were then excised completely. The bone was then trimmed back towards smooth surface. The germinal matrix was then able to be repaired and did not require full-thickness grafting, but this was able to be advanced in and smoothed out; however, about 8-mm wide section of the sterile matrix required debridement and partial-thickness grafting for the appropriate contours
The left second toenail was removed and using a template, a split-thickness nail bed graft was then harvested from the left second toe. The toenails were placed and secured with 5-0 chromic sutures. The split nail graft was then trimmed to fit the defect and inset with interrupted 5-0 chromic sutures as well as the repair of the germinal matrix. Next, a foil from the suture pack was then cut into a nail shape and placed into the nail fold to stent this open. The nail fold incisions were closed with interrupted 5-0 chromic as well as suturing down the artificial nail from the foil pack.
I'm thinking 11762 and 15050. I could really be wrong on the 15050 but it isn't a big area to cover and I'm wondering if I'm missing the nail removal on the second toe. Should I also code for the bone aspect?
Any help is greatly appreciated because I'm on my last patch of hair on my head. I'm about to pull that out as well. Have a great weekend.