Ortho Op Report--Removal capitellum-HELP

AR2728

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I can't locate a CPT for this procedure. Am I missing something or is this unlisted?

POST OPERATIVE DIAGNOSIS: 1) Left elbow capitellum fracture.
2) Left elbow trochlear fracture.

At this point in time the elbow was then flexed and a cochlear approach was taken to the left elbow. Skin was incised with a 15 blade. Dissection continued down between the anconeus and the extensor carpi ulnaris. At this point it was then taken, the capsule was then incised. At this point in time the joint was viewed. The patient had a small fracture of the radial head and she also had a fracture of the capitellum which was severely displaced. Attempt was made to reduce the fracture. Two 2.7 screws were placed. However due to severe comminution in the osteoporotic bone, no fixation could be achieved. Several attempts were made. At this point in time due to the fact that the bone was nearly striped of all soft tissue. The capitellum was removed. The trochlear was left in place. At this point in time the wound was copiously irrigated with normal saline and the tourniquet was let down. There is no significant bleeding. Deep tissue was then closed with #1 Ethibond. Subcutaneous tissue closed with 2-0 vicryl suture. Skin was closed with 3-0 running nylon suture. The incision was injected with 30 cc. ¼% Marcaine plain. A sterile soft dressing of Xeroform 4X4, Webril and a long arm posterior splint was placed. The patient went to recovery in stable condition.
 

AR2728

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I asked my physician about that code and he stated that he did not enter the joint capsule, which the code explanation states is incised. I was hoping he had...it would have made this much easier to code. Any other suggestions?
 

scooter1

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The only other code I could come up with was 24200 or 24201. However, it really isn't a foreign body. So the only other recourse would be the unlisted. . . . . . sorry
 

AR2728

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I appreciate your feedback. It's always reassuring to get advice from others especially before using an unlisted code. They intimidate me!
 
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