queeniek
Contributor
One of our physicians did an Right Periacetabular Osteotomy with application of external fixator. One week later, post op x-ray indicates loss of reduction, so he performed what he is calling "osteotomy revision".
His procedure note reads:
Prior anterior skin incision was opened and inguinal ligament + Sartorious were retracted medially, taking the LFCN with them, protecting it. Inner ilium was dissected from iliacus muscle bluntly, with a cob and swab. Hematoma and debris were cleared off. Irrigation was done and the central acetabular fragment (CAF) was found to have externally rotated and moved laterally. Retractors were placed and 2 of 3 screws were removed. 2 Shanz screws were placed then in the prior drill holes and attached to a external fixator. At this point remaining screw was also removed and the CAF was mobilized. Manual realignment of the *central acetabular fragment was done and provisional fixation was done with the guide wires for the screws and correction was checked with a intraoperative X ray. This was compared with pre operative x rays and the correction was found to be acceptable. *After confirmation of correction using fluoroscopy in AP and false profile planes, the fragment was fixed with 2-*4.5mm**full threaded*cortical screws and one 6.5 mm fullly threaded cancellous screw. Fixation found to be stable and irrigation was done.
*
Inguinal ligament and Sartorious were attached back to ASIS using 1 vicryl. *Incision was closed according to soft tissue layers using 1 vicryl and 2-0 vicryl.*Skin was closed with*subdermal Monocryl.*Final fluoro shots were obtained to confirm position/correction.
Based off of this note, how would this be billed?
Thank you
His procedure note reads:
Prior anterior skin incision was opened and inguinal ligament + Sartorious were retracted medially, taking the LFCN with them, protecting it. Inner ilium was dissected from iliacus muscle bluntly, with a cob and swab. Hematoma and debris were cleared off. Irrigation was done and the central acetabular fragment (CAF) was found to have externally rotated and moved laterally. Retractors were placed and 2 of 3 screws were removed. 2 Shanz screws were placed then in the prior drill holes and attached to a external fixator. At this point remaining screw was also removed and the CAF was mobilized. Manual realignment of the *central acetabular fragment was done and provisional fixation was done with the guide wires for the screws and correction was checked with a intraoperative X ray. This was compared with pre operative x rays and the correction was found to be acceptable. *After confirmation of correction using fluoroscopy in AP and false profile planes, the fragment was fixed with 2-*4.5mm**full threaded*cortical screws and one 6.5 mm fullly threaded cancellous screw. Fixation found to be stable and irrigation was done.
*
Inguinal ligament and Sartorious were attached back to ASIS using 1 vicryl. *Incision was closed according to soft tissue layers using 1 vicryl and 2-0 vicryl.*Skin was closed with*subdermal Monocryl.*Final fluoro shots were obtained to confirm position/correction.
Based off of this note, how would this be billed?
Thank you