pip joint debridement- please help

ladymatthew

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I am not sure whether or not to bill this procedure here or not..... I have captured the ganglion excision but could you please advise me as to what code would be most appropriate for debridement in this case? I was directed to use 26110 but I am not sure that is correct because there was no "biopsy" taken.... I'm just not sure about how to bill for the removal of the bone spur.... can anyone give me some direction? thanks!


the operative report reads:

OPERATIONS PERFORMED:
1. Excision of left finger pip joint mucous cyst
2. Debridement of the left ringer finger pip joint

DESCRIPTION OF PROCEDURE:
After appropriate preoperative informed consent was obtained, the patient was taken to the operating room and placed in a supine position with the left upper extremity on arm table. The left arm was prepped and draped in the usual sterile fashion. The arm was exsanguinated below the level of the lesion. The tourniquet was inflated. A curved incision was made over the dorsum of the ring finger centered over the PIP joint. The skin flap was elevated. This exposed what appeared to be a synovial cyst. The cyst sat midline emanating from the extensor tendon. It was excised. On the surface of the extensor tendon, it was noted the cystic contents continued to drain from underneath the extensor tendon. Thus a longitudinal rent was made in the tendon allowing the tendon to be retracted radially and laterally. The mucous cyst was present underneath the tendon itself. It was excised in its entirety. There was a large bone spur radially associated with the cyst and this was smoothed down using a ronguer. The wouldn't was copiously irrigated. The longitudinal rent and extensor tendon were repaired using 4-0 vicryl. The tourniquet was deflated.
 
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