Question Thumb CMC arthroplasty & scaphotrapezoid excision w/interposition arthroplasty

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I need help with the above. Physician gave me 25447 x 2 with 25310. Insurance only paid on one 25447. I'm thinking 26480 instead of 25310. I'm also not sure if this is 2-25447.

brief description:...a modified Wagner approach was done to the CMC jt of thumb. The periosteum was incised from the volar aspect of the trapezium and the exicison was then split with an osteotome and excised of any loose bodies. There was complete full-thickness loss on the distal pole of the scaphoid abutting both the trapezium and trapezoid. 2mm of trapezoid was excised with osteotome. Next the FCR was identified. It was then transected proximally and split into two. Next a Hohmann retractor was placed around the ulnar border of the thumb metacarpal. One half of the FCR was taken into the thumb metacarpal. It was then taken back into the trapezial space and brought back out. Next a 3-cm segment of the half othe FCR was sutured in a ball with the Ethibond . It was sutured into the scaphotrapezoid space. Next the other hal of the FCR was sutured in the trapezial space.
Thanks.
 

Orthocoderpgu

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25447 should only be billed once. Removing both the trapezium and trapezoid are included with 25447. The tendon transfer is reported separately but the code will depend on the location of where this is obtained. Since a separate incision was not made to obtain the tendon for the transfer, the code would be 26480.
 
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25447 should only be billed once. Removing both the trapezium and trapezoid are included with 25447. The tendon transfer is reported separately but the code will depend on the location of where this is obtained. Since a separate incision was not made to obtain the tendon for the transfer, the code would be 26480.
I was looking all over for an answer to this - thank you!
 
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