I am hopeful someone can assist me. Our Podiatrist did a Sural Neurectomy right ankle. No other procedures were completed. I attached a bot 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. I am wondering if 28055 Neurectomy, intrinsic musculature of foot would be more appropriate.
Any assistance would be appreciated.
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. I am wondering if 28055 Neurectomy, intrinsic musculature of foot would be more appropriate.
Any assistance would be appreciated.