Question Removal of foreign body in bone of hand


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Hi all,

Looking for a CPT code for - Removal of foreign body in bone of hand - Surgeon wants to use 20680, but I do not think that is correct.

After Eshmarch exsanguination, the pneumo-tourniquet was inflated to 250 milimeters of mercury about the upper arm.  A 1 cm. incision was fashioned incorporating the entry wound.  Dissection was carried carefully through the subcutaneous tissue identifying and protecting the neurovascular structures.  The skin flaps were raised full thickness and were carefully retracted.  The foreign body  was encountered.  The soft tissues were dissected free of the foreign body .  The foreign body was found to be securely lodged in the bone with 2 small adjacent metallic fragments all of which were  removed intact.  Final inspection revealed no further visible abnormality.  There was no apparent involvement of the flexor tendons or neurovascular structures.  The wound was irrigated copiously with sterile saline for irrigation.  The pneumo-tourniquet was deflated after a period of 5 minutes elevation. The fingers & flap were immediately pink and well perfused.  Hemostasis was easily obtained with direct pressure and electrocautery and the wound was closed with interrupted absorbable sutures in the skin.  The wound was dressed with adaptic, dry sterile dressings, and a very well padded hand and finger dressing was applied.

TIA - Kris