solocoder
Expert
Could I please get some opinions on how to code this surgery? Prior to the surgery I was planning on coding this as 28112, but the pinning was a surprise.
PREOPERATIVE DIAGNOSIS: Freiberg's infraction second metatarsal, right.
PROCEDURE PERFORMED:
1. Second metatarsal head resection, right.
2. Pinning right second toe.
Attention was then directed to dorsal aspect of the second metatarsal. A linear incision was made overlying this area. Dissection was carried to bone. Subperiosteal dissection was performed allowing for exposure of second metatarsal head. A sagittal saw was then used to resect the metatarsal head. This was then dissected free. Upon evaluation, there was some erosion to over 50% of the metatarsal head consistent with Freiberg's infraction. The remaining soft tissues appeared clean and viable. Decision was made to place a K-wire into the second toe spanning the area of the second metatarsophalangeal joint for stability. Fluoroscopy images were obtained and fixation was noted to be good.
PREOPERATIVE DIAGNOSIS: Freiberg's infraction second metatarsal, right.
PROCEDURE PERFORMED:
1. Second metatarsal head resection, right.
2. Pinning right second toe.
Attention was then directed to dorsal aspect of the second metatarsal. A linear incision was made overlying this area. Dissection was carried to bone. Subperiosteal dissection was performed allowing for exposure of second metatarsal head. A sagittal saw was then used to resect the metatarsal head. This was then dissected free. Upon evaluation, there was some erosion to over 50% of the metatarsal head consistent with Freiberg's infraction. The remaining soft tissues appeared clean and viable. Decision was made to place a K-wire into the second toe spanning the area of the second metatarsophalangeal joint for stability. Fluoroscopy images were obtained and fixation was noted to be good.