Wiki tophi and amputation


Marshfield, MO
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Can someone please tell me if this "excision of gouty tophi" could be separately billed with the toe amputation? If so, I am stumped as to what the correct code would be. The amputation wasn't FOR gout, but for gangrene, if it makes a difference. Appreciate any help!

By using sharp dissection, transverse capsulotomy was performed through the dorsal aspect of the first metatarsophalangeal joint, and the medial and lateral collateral ligaments were identified and transected. The digit was amputated in toto from the area.

At this time, it was noted that the head of the 1st metatarsal was almost completely covered with white chalky material that appears to be tophi deposits. The Extensor Hallucis Longus tendon overlying the 1st metatarsal head was also noted to have tophi deposits. Excisional debridement of the tophi was performed using a scalpel and bone rongeur from the Extensor Hallucis Longus tendon until healthy-appearing tendon was noted. Bone rongeur was also used to debride the head of the 1st metatarsal free of all the visible tophi deposits.