I think you need to answer some questions first. You have "Left trigger thumb" and "Left trigger thumb injection". Was the A1 pulley released? If it were they would never release the A1 pulley and inject it too. You also have listed a "Right Carpal Tunnel Release" once, but 64721-RT and "Injection carpal tunnel" but you don't say what side it was performed on. Once again you would never perform a CTR 64721 and then inject the same time. It's one or the other and I have had both. The injection only worked for a short time so then they performed the surgery afterwards. Your codes are not matching the procedures listed.
Sorry for the disruption of the note... I will give you a clearer view of the op note this time... I did not mean to mention the Trigger thumb twice... and the A1 pulley of the thumb was not released.
Hopefully this is much more of a better picture... sorry for the confusion.
Carol
I will appreciate your expertise....
Injection left Trigger Thumb
Injection, left small finger trigger digit
Rt Carpal tunnel release.
On the Skin I prepped the skin overlying the A1 pulley of the thumb and the A1 pulley of the ring and small fingers. 40 mg Depo-Medrol was injected overlying the A1 pulley of the thumb and between the A1 pulleys of the ring and small fingers, essentially directed the needle toward the small finger for the part of the injection and toward the ring finger for the other..
The right hand and arm were then prepped and a longitudinal incision was made proximal to Kaplans line and distal to the volar wrist crease in line with the radial border of the ring finger. Dissection carried to the subcu.
Dr. spread the palmar fascia and identified the transverse carpal ligament. exposing the median nerve. Identified the motor branch distally and radially and then released the transverse carpal ligament proximally and released the distal 1 cm of the volar forearm fascia. At this point two leaves of the transverse carpal ligament lay open. . the skin was reapproximated and sutured.