Need help with op note - blunt technique

nsteinhauser

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I'd appreciate any thoughts on coding this...

Attention was directed to the left foot where a linear incision was made from the first mid shaft of the metatarsal to the mid shaft proximal phalanx medial to the extensor hallucis longus tendon. Dissection was carried out using sharp and blunt technique. All neurovascular structures were identified and coagulated as necessary. The capsule was identified; a T-shaped capsulotomy was performed. Capsule and periosteum removed using sharp and blunt technique. Prominent medial eminence was removed. Dorsal spur off the first metatarsal head was removed via cheilectomy and then a compression osteotomy from dorsal distal to plantar proximal was achieved and sat plantarly as much as possible and moved laterally to correct mild bunion formation. Foot was impacted loaded. Good correction of previous deformity noted. The osteotomy site was fixated using a 28 mm 4-0 cannulated screw. Good compression of the osteotomy site was noted. Remaining roughened surfaces were removed using sagittal saw and a rotating burr. Sterile saline was used to flush the surgical site area. A medial capsulorrhaphy was then performed, and closed using.......

I was looking at 28296.......then the cheilectomy had me looking at 28306 with 28289. The surgeon said use 28306 with 28122. If anyone has any thoughts about this, I'd appreciate it. Thank you!
 
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