My Podiatrist did a Percutaneous syndesmotic screw placement on a patient and he coded 27829, which I know is wrong. I'm thinking that I'm going to have to use an unlisted code, 27899. I need another opinion please. Here's the meat of the op note:
Utilizing an Esmarch bandage, the right foot, ankle and lower leg region was exsanguinated and the pneumatic thigh tourniquet raised to 350 mmHg. At this point in time, attention was directed to the lateral aspect of the right ankle joint where the anterior and posterior portions of the fibula were drawn out, and then utilizing a C-arm to visualize appropriate syndesmotic screw placement, a 1 cm proximal to distal linear incision was made along the fibular shaft. Dissection was carried down to the fibular bone. Utilizing the guidewire for a 4.0 mm Metasurg partially threaded screw was inserted through the fibula through the syndesmosis and into the tibia under C-arm guidance. Lateral radiograph confirmed good placement of the guidewire. Over-drilling of the guidewire was performed followed by countersinking and measuring and insertion of a 4.0 mm partially threaded Metasurg screw. Final C-arm radiographs confirmed good placement of the screw.
Elaine
Utilizing an Esmarch bandage, the right foot, ankle and lower leg region was exsanguinated and the pneumatic thigh tourniquet raised to 350 mmHg. At this point in time, attention was directed to the lateral aspect of the right ankle joint where the anterior and posterior portions of the fibula were drawn out, and then utilizing a C-arm to visualize appropriate syndesmotic screw placement, a 1 cm proximal to distal linear incision was made along the fibular shaft. Dissection was carried down to the fibular bone. Utilizing the guidewire for a 4.0 mm Metasurg partially threaded screw was inserted through the fibula through the syndesmosis and into the tibia under C-arm guidance. Lateral radiograph confirmed good placement of the guidewire. Over-drilling of the guidewire was performed followed by countersinking and measuring and insertion of a 4.0 mm partially threaded Metasurg screw. Final C-arm radiographs confirmed good placement of the screw.
Elaine