Wiki Question

coderbeth

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Randleman, NC
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I need a little help here, I have gotten advice that I don't think is correct.

Attention was directed to the left heel, where a stab incision was performed over the medial heel with an 11 blade and blunt dissection was performed with a hemostat down to the plantar fascia. Under ultrasound guidance, the Tenex Bbone was set on low settings and used to perform debridement of the plantar fascia, thus performing a percutaneous plantar fasciectomy through the Tenex ultrasonic debrider without incident. Next, the settings were changed to high and the Tenex Bone was used to remove the infracalcaneal exostosis on the plantar heel without incident and fluoroscopy was used to show resectional dissection. The operative site was irrigated with normal saline and wound was closed with 3-0 nylon.



Attention was turned to the posterior heel where stab incisions were performed medially and laterally and the Tenex Bone procedure was used to perform ultrasonic debridement of the Achilles tendon and resection of the calcific tendinitis of the posterior heel under fluoroscopic guidance. After adequate resection, one final view was saved for the record. The operative site was copiously irrigated with normal saline and skin closed with _____ of 3-0 nylon. The foot was cleaned with normal saline-soaked gauze, dried and a dressing of Xeroform, 4 x 4, gauze wrap and Ace wrap was placed about the extremity.



The patient tolerated the procedure well and transferred to recovery with vital signs stable and vascular status intact to the left lower extremity. She can be discharged home. Is instructed to be nonweightbearing, wear postoperative shoe on the left, elevate the extremity above the heart and follow up with me next week. She was given prescriptions for Norco and Naproxen, which were sent to her pharmacy on file.

The advice given is : 27654,28118 and 28060
I don't see where they repaired the achilles..
I was thinking 28119 with unlisted 27899 but I feel like that bundles as well

Any advice here?
 
28060 plantar fasciectomy
27654 Achilles tendon debridement
28119 calcaneal exostectomy for spur
According to my research, these would be the appropriate codes. Append with 59 modifier where appropriate, check the cci edits.
 
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