Merlin0728
Networker
We are looking for opinions on coding the procedure below. It was performed at the same time as a triple arthrodesis (28715).
We were thinking 27630 excision of lesion of tendon sheath or capsule due to the scar being removed but the insurance company denied after receiving the Op Report. Otherwise we figured an unlisted code.
This is the portion of the Op Report related to what the surgeon describes as a synovectomy and decompression, left tibialis posterior tendon sheath:
A third surgical incision was then made over the posterior border of the medial malleolus measuring approximately 2.5 cm in length. Subcutaneous tissues were taken down using sharp dissection until the periosteum of the distal medial malleolus was identified. The tibialis posterior tendon sheath was then opened and the tibialis posterior tendon was noted to be scarred but intact. The scar was removed and the synovitis resected using a rongeur. The tibialis posterior tendon sheath was then loosely reapproximated in order to decompress. This was done using #1 Vicryl suture. Subcutaneous tissues were reapproximated using 2-0 Vicryl sutures in an interrupted fashion and the skin was closed using skin staples.
Thank you for any suggestions you may have!
We were thinking 27630 excision of lesion of tendon sheath or capsule due to the scar being removed but the insurance company denied after receiving the Op Report. Otherwise we figured an unlisted code.
This is the portion of the Op Report related to what the surgeon describes as a synovectomy and decompression, left tibialis posterior tendon sheath:
A third surgical incision was then made over the posterior border of the medial malleolus measuring approximately 2.5 cm in length. Subcutaneous tissues were taken down using sharp dissection until the periosteum of the distal medial malleolus was identified. The tibialis posterior tendon sheath was then opened and the tibialis posterior tendon was noted to be scarred but intact. The scar was removed and the synovitis resected using a rongeur. The tibialis posterior tendon sheath was then loosely reapproximated in order to decompress. This was done using #1 Vicryl suture. Subcutaneous tissues were reapproximated using 2-0 Vicryl sutures in an interrupted fashion and the skin was closed using skin staples.
Thank you for any suggestions you may have!