Please help with TMA revision coding

djh803

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How would this revision be coded, as an amputation (28805) or debridement?

Using a marking pen, the prior amputation site was examined and a line drawn demarcating gangrenous tissue from healthy-appearing tissue measuring approximately 1 cm from the skin edge proximal. Using a #15 blade scalpel, an incision was made at the tissue with sharp excisional debridement down to the bone and removal of approximately 1cm of distal tissue. Using a reciprocating saw, approximately 1 cm of patient's 5 metatarsal bones were resected with additional tissue removed with heavy scissors. The remaining flap then had approximately 1 cm of dead tissue removed and sharp debridement was made of any remaining dead and necrotic tissue. Any bleeders found were cauterized using electrocautery. The wound was then further debrided using approximately 3 L of sterile normal saline using a Pulsavac. The field was then dried and any remaining bleeders cauterized with electrocautery. The wound at this time appeared pink and healthy with a minimal amount of oozing blood.
 
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