jvanek82
True Blue
Good morning!
I have been assigned to code for a sports medicine provider who does Tenjet tenotomies and I am not in agreement with the codes he wants to use. I am not that familiar with these codes and need some guidance. The provider wants to bill 27299, 27307, 27062. 20550 and 76942. I don't see the open code for the trochanteric bursa (which appears to be through the same incision as the tenotomies). The provider is telling me that he did a stab incision which he says is an open procedure, not percutaneous. Yet he says in the beginning he did a percutaneous tenotomy. I would appreciate any help with this including any information to support if this is an open or percutaneous procedure or how to explain the difference to the provider.
PROCEDURE DETAILS:
A minimally invasive, ultrasound guided percutaneous tenotomy was performed to remove the pathologic degenerative tendon tissue using the TenJet Hydrocission device.
The site was confirmed with the patient and marked with a marking pen. History and physical consent were reviewed and placed in the chart. Point of maximal tenderness was marked. The patient was then transported by nursing staff to the procedure room. Time-out was held to confirm the RIGHT lower extremity as correct operative site.
The anatomy was identified, and the diseased tissue was visualized using ultrasound guidance. The area was prepped using chloraprep and anesthetized with 10 cc of 1% lidocaine with epinephrine using a 22 gauge 3 in needle. An #11 blade was used to make a stab incision through the skin at the site of needle entry. A sterile sleeve was placed over the ultrasound transducer. After tubing was prepared and primed, the device was introduced through the puncture site advancing to the diseased tendon under ultrasound guidance. Once the tip of the instrument was confirmed to be on the pathologic tissue, the foot pedal was depressed and the diseased/pathologic portions of the gluteus medius and gluteus minimus tendon was resected and removed. In addition, several fenestrating passes were made to the overlying greater trochanteric bursa. Lastly, significant striations of calcification were noted within the gluteus medius tendon and gluteus minimus tendon, these were resected and removed successfully. Under continued ultrasound guidance, the device was moved back and forth and rotated to target all areas of the diseased area until satisfactory changes were observed on ultrasound imaging.
Following the procedure, Dermabond was placed over the incision followed by a Tegaderm. Post procedure instructions were given to the patient who verbalized understanding. The patient tolerated the procedure well and was discharged from clinic in good condition.
Thanks for your help!
I have been assigned to code for a sports medicine provider who does Tenjet tenotomies and I am not in agreement with the codes he wants to use. I am not that familiar with these codes and need some guidance. The provider wants to bill 27299, 27307, 27062. 20550 and 76942. I don't see the open code for the trochanteric bursa (which appears to be through the same incision as the tenotomies). The provider is telling me that he did a stab incision which he says is an open procedure, not percutaneous. Yet he says in the beginning he did a percutaneous tenotomy. I would appreciate any help with this including any information to support if this is an open or percutaneous procedure or how to explain the difference to the provider.
PROCEDURE DETAILS:
A minimally invasive, ultrasound guided percutaneous tenotomy was performed to remove the pathologic degenerative tendon tissue using the TenJet Hydrocission device.
The site was confirmed with the patient and marked with a marking pen. History and physical consent were reviewed and placed in the chart. Point of maximal tenderness was marked. The patient was then transported by nursing staff to the procedure room. Time-out was held to confirm the RIGHT lower extremity as correct operative site.
The anatomy was identified, and the diseased tissue was visualized using ultrasound guidance. The area was prepped using chloraprep and anesthetized with 10 cc of 1% lidocaine with epinephrine using a 22 gauge 3 in needle. An #11 blade was used to make a stab incision through the skin at the site of needle entry. A sterile sleeve was placed over the ultrasound transducer. After tubing was prepared and primed, the device was introduced through the puncture site advancing to the diseased tendon under ultrasound guidance. Once the tip of the instrument was confirmed to be on the pathologic tissue, the foot pedal was depressed and the diseased/pathologic portions of the gluteus medius and gluteus minimus tendon was resected and removed. In addition, several fenestrating passes were made to the overlying greater trochanteric bursa. Lastly, significant striations of calcification were noted within the gluteus medius tendon and gluteus minimus tendon, these were resected and removed successfully. Under continued ultrasound guidance, the device was moved back and forth and rotated to target all areas of the diseased area until satisfactory changes were observed on ultrasound imaging.
Following the procedure, Dermabond was placed over the incision followed by a Tegaderm. Post procedure instructions were given to the patient who verbalized understanding. The patient tolerated the procedure well and was discharged from clinic in good condition.
Thanks for your help!