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Just wanted a second opinion to see if I'm headed in the right direction:
Procedure: Hip I&D,Girdlestone Procedure, Removal of cement spacer, Extended Trochanteric osteotomy.
An incision was made over the greater trochanter....copious amounts of purulent fluid was removed from the wound and cultured...Attention was turned toward removing the cement ball off of the trunnion. With the use of the Moreland cement removal instruments, the cement ball was broken up into pieces and removed from the trunnion. Next soft tissue was removed from around the calcar and the implant was removed with the use of electrocautery. Then the proximal cement mantle was disrupted with the use of the high-speed bur.
Given the extensive amount of cement in the patient's canal, the decision was made to proceed with an extended trochanteric osteotomy to remove all of the cement. The osteotomy extended from the greater trochanter to approximately 2-3cm proximal to the distal cement plug. The osteotomy was completed from posterior to anterior with the use of a sagittal saw. osteotomy was completed with the help of some osteotomes and the lateral fragment was then slipped anteriorly to expose the cement mantle.
Next attention was turned toward the the lateral fragment and the cement mantle from the lateral fragment was also removed with the use of the Moreland hand cement removal instruments...
I first came up with 27091, 27030, 11982 and was looking at 27165 for the osteotomy. But I think 27140 might be a better code for the osteomy. If so then 27030 and 27140 would be inculsive of 27091 leaving me with:
27091
11982
Would you agree or do you think 27165 would be a better code for the osteotomy? Thanks.
Procedure: Hip I&D,Girdlestone Procedure, Removal of cement spacer, Extended Trochanteric osteotomy.
An incision was made over the greater trochanter....copious amounts of purulent fluid was removed from the wound and cultured...Attention was turned toward removing the cement ball off of the trunnion. With the use of the Moreland cement removal instruments, the cement ball was broken up into pieces and removed from the trunnion. Next soft tissue was removed from around the calcar and the implant was removed with the use of electrocautery. Then the proximal cement mantle was disrupted with the use of the high-speed bur.
Given the extensive amount of cement in the patient's canal, the decision was made to proceed with an extended trochanteric osteotomy to remove all of the cement. The osteotomy extended from the greater trochanter to approximately 2-3cm proximal to the distal cement plug. The osteotomy was completed from posterior to anterior with the use of a sagittal saw. osteotomy was completed with the help of some osteotomes and the lateral fragment was then slipped anteriorly to expose the cement mantle.
Next attention was turned toward the the lateral fragment and the cement mantle from the lateral fragment was also removed with the use of the Moreland hand cement removal instruments...
I first came up with 27091, 27030, 11982 and was looking at 27165 for the osteotomy. But I think 27140 might be a better code for the osteomy. If so then 27030 and 27140 would be inculsive of 27091 leaving me with:
27091
11982
Would you agree or do you think 27165 would be a better code for the osteotomy? Thanks.