How would you code a trigger finger release with excision of dupuytren's nodule?
#1 - 26160, 26055-59?
#2 - 26123?
The tourniquet was inflated to 200 mmHg and a 2cm bruner incision over the A1 pulley of the left ring finger and proximally over the dupuytrens disease. Starting proximally we identified the dupuytrens cord and then sharply dissected it from the skin creating full thickness flaps. The neurovascular bundles were identified and we then proceeded distally protecting the digital nerves and vessels. Once the dupuytrens was fully excised we went ahead and bluntly dissected down to the A1 pulley and then Ragnell retractors utilized to protect the digital nerves on either side. The A1 pulley was visualized, a hemostat placed under the A1 pulley and withdrawn until a click was appreciated between the A1 and A1 pulleys and then the A1 pulley was incised sharply with a scalpel. A ragnell retractor was used to gently pull and separate any scarring between the profundus and superficialis tendons. Any additional fibers were freed up distally and proximally using blunt dissection freeing up any proximal tethering fibers and the patient was asked to make a fist to make sure there was no triggering.
Thanks in advance.
#1 - 26160, 26055-59?
#2 - 26123?
The tourniquet was inflated to 200 mmHg and a 2cm bruner incision over the A1 pulley of the left ring finger and proximally over the dupuytrens disease. Starting proximally we identified the dupuytrens cord and then sharply dissected it from the skin creating full thickness flaps. The neurovascular bundles were identified and we then proceeded distally protecting the digital nerves and vessels. Once the dupuytrens was fully excised we went ahead and bluntly dissected down to the A1 pulley and then Ragnell retractors utilized to protect the digital nerves on either side. The A1 pulley was visualized, a hemostat placed under the A1 pulley and withdrawn until a click was appreciated between the A1 and A1 pulleys and then the A1 pulley was incised sharply with a scalpel. A ragnell retractor was used to gently pull and separate any scarring between the profundus and superficialis tendons. Any additional fibers were freed up distally and proximally using blunt dissection freeing up any proximal tethering fibers and the patient was asked to make a fist to make sure there was no triggering.
Thanks in advance.