I posted this in the Orthopedic group and received one reply suggesting 67407 or 67408 which are Neuroplasty codes for decompression of the nerve. The other suggestion was 64772 which is Transection or avulsion of other spinal nerve, extradural. Both are great suggestions, but I thought I would try here and see if anyone can assist.
Our Podiatrist did a Sural Neurectomy right ankle. No other procedures were completed. I attached a bit of his note below:
INDICATIONS FOR SURGERY: complains of pain to the right lateral ankle and foot which pain has been unresponsive to conservative treatment with progression of pain with time.
PROCEDURE IN DETAIL: "A 4.5 cm linear incision was placed between the lateral malleolus and the Achilles tendon over the posterolateral ankle extending proximal to the ankle joint and along the course of the sural nerve. The incision was deepened to the subcutaneum with care taken to identify and retract vital neurovascular structures. Ligation and/or cautery were used as needed for hemostasis. In particular, the sural nerve was identified and gently dissected along the course of the incision. 3.2 cm of the distal sural nerve was excised."
INTRAOPERATIVE FINDINGS: normal appearing sural nerve noted at the level of the right posterolateral ankle, just posterior to the lateral malleolus; approximately 3.2 cm of nerve were excised; excellent hemostasis.
I spoke with the provider, and he kept taking me back to the 64774-64778 - Excision of neuroma, however he did again state the patient does not have a neuroma this is purely for pain.
Any assistance would be appreciated.
Our Podiatrist did a Sural Neurectomy right ankle. No other procedures were completed. I attached a bit of his note below:
INDICATIONS FOR SURGERY: complains of pain to the right lateral ankle and foot which pain has been unresponsive to conservative treatment with progression of pain with time.
PROCEDURE IN DETAIL: "A 4.5 cm linear incision was placed between the lateral malleolus and the Achilles tendon over the posterolateral ankle extending proximal to the ankle joint and along the course of the sural nerve. The incision was deepened to the subcutaneum with care taken to identify and retract vital neurovascular structures. Ligation and/or cautery were used as needed for hemostasis. In particular, the sural nerve was identified and gently dissected along the course of the incision. 3.2 cm of the distal sural nerve was excised."
INTRAOPERATIVE FINDINGS: normal appearing sural nerve noted at the level of the right posterolateral ankle, just posterior to the lateral malleolus; approximately 3.2 cm of nerve were excised; excellent hemostasis.
I spoke with the provider, and he kept taking me back to the 64774-64778 - Excision of neuroma, however he did again state the patient does not have a neuroma this is purely for pain.
Any assistance would be appreciated.