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Wiki Tendon Z plasty dislocation treatement

jvargocpc

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Cass City, MI
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Hello everyone!

I have a patient who had rigid contracture with dislocation of the MPJ of T7 toe.

Podiatrist documents he did capsulotomy of the MPJ, resection of the third metatarsal head to the level of the surgical neck, K-wire insertion through all three phalanges into the remainder of the metatarsal, and Z-plasty lengthening of the extensor digitorum longus tendon.

My question is if the Z-plasty is a component of the open treatment of the dislocation.

The codes I am using are 28645 (Open treatment of metatarsophalangeal joint dislocation, included internal fixation, when performed) and...

28112 (Ostectomy, complete excision; second, third or fourth metatarsal head.)

So do I also need a CPT for the Z-plasty? If so, what would I use? 3M comes up with an unlisted procedure, but I've learned to not always trust 3M!!! However, I don't see anything else jumping out at me either.

Thanks for any help with this!
 
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