open drilling of osteochondritis

trose45116

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what would you code for this?


PREOPERATIVE
DIAGNOSIS:

Osteochondritis desiccans, left talus, superomedial dome.


POSTOPERATIVE
DIAGNOSIS:

Osteochondritis desiccans, left talus, superomedial dome.


PROCEDURE: Open drilling of osteochondritis.

ANESTHESIA: General.

ESTIMATED
BLOOD LOSS: None.


COMPLICATIONS: None.



DESCRIPTION OF PROCEDURE: The patient was placed on the operating table in the supine position and prepped and draped for surgery on the left foot in the usual manner. Under tourniquet control, and anteromedial incision was made over the ankle joint, and soft tissue divided down to the capsule which was opened. With retraction, the talus was visualized and showed good excursion under the tibial plafond with range of motion. It was squishy and soft in the superomedial area, but the articular cartilage was intact. About 10 small drill holes were made in the area corresponding to the osteochondritis on MRI scan. The drill holes were deep enough to get down to good vascular bone to revascularize the area. The wound was then thoroughly irrigated to relieve debris, and the capsule was closed with 2-0 Vicryl, the subcutaneous tissue with 2-0 Vicryl, and the skin with Monocryl. Marcaine with no epinephrine was injected in the wound for analgesia. A sterile dressing was applied. The patient returned to the recovery room in good condition.
 
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