Wiki Need help-Does anyone have

[pittiemom2722]

Does anyone have any experience coding an Ertl procedure/stump revision? I'm looking at CPT 27886. In the explanation it states the physicial surgically cuts the tib/fib individually to complete the re-amputation. My doctor says he would be "trimming the tib/fib about one-quarter inch" so is that enough to justify this code? And he is planning on tying the nerves as well which is also in the description.......help!

Kris

 

[pittiemom2722]

Anyone?

 

[jmcpolin]

Yes I would use that code it includes the cut of the tib fib and the tying of the nerves.

The physician performs an amputation on the leg below the knee in a patient who has already undergone amputation. The physician identifies the additional area of the remaining stump requiring amputation. An incision is made in the skin at the appropriate site and extended laterally and medially around the leg. The tissue is dissected to the bones. The large arteries, veins, and nerves are identified and tied off prior to being cut. Tissue is further debrided as needed. The physician surgically cuts the tibia and fibula individually to complete the reamputation. The wound is irrigated with antibiotic solution. The wound and skin may be closed in layers. If infection is present, the incision may be temporarily left open to drain.