jvanek82
True Blue
Good morning!
Please help with code selection for this procedure. The provider believes the codes that need to be billed are 20550, 24357, 76942 and 24341. I am in disagreement! 20550 is for administration of the anesthesia, not billable and I do not see CPT code 24341. Please let me know if I am missing something! Thanks!
Indications:
* Calcific tendinitis of left elbow [M65.222]
* Left lateral epicondylitis [M77.12]
* Partial tear of common extensor tendon of left elbow [
S56.512A].
Procedure Details:
A minimally invasive, tenotomy was performed to remove pathologic degenerative tendon tissue using the TenJet Hydrocision device.
The site was confirmed with the patient and marked with a marking pen. History and physical, as well as informed consent, were reviewed and placed in the chart. The point of maximal tenderness was identified and marked. The patient was then transported by nursing staff to the procedure room. Time-out was held to confirm the [right/left] upper extremity as the correct operative site.
The anatomy was identified, and the diseased tissue was visualized using real-time ultrasound guidance. The area was prepped using chloraprep and anesthetized with 15 cc of 1% lidocaine with epinephrine using a 27 gauge 1.5 in needle under ultrasound guidance.
An #11 blade was used to make an incision over the level of the affected tendon for access to the target tissue. A sterile sleeve was placed over the ultrasound transducer.
To treat the diseased tendon, the surgical instrument was introduced through the incision and advanced to the pathologic tendon under ultrasound guidance. Once the tip of the instrument was confirmed within the pathologic tissue, the device was activated and the diseased/pathologic portions of the common extensor tendon were resected and removed.
In addition, several fenestrating passes were made to the overlying common extensor tendon to further address areas of tendinosis. Significant striations of calcification were noted within the tendon origin at the lateral epicondyle region, and these calcifications were debrided and removed.
Under continued ultrasound guidance, the device was moved back and forth and rotated to target all areas of diseased tissue until satisfactory changes were observed on ultrasound imaging.
Following the procedure, Dermabond was placed over the incision followed by a Tegaderm dressing. 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.
Please help with code selection for this procedure. The provider believes the codes that need to be billed are 20550, 24357, 76942 and 24341. I am in disagreement! 20550 is for administration of the anesthesia, not billable and I do not see CPT code 24341. Please let me know if I am missing something! Thanks!
Indications:
* Calcific tendinitis of left elbow [M65.222]
* Left lateral epicondylitis [M77.12]
* Partial tear of common extensor tendon of left elbow [
S56.512A].
Procedure Details:
A minimally invasive, tenotomy was performed to remove pathologic degenerative tendon tissue using the TenJet Hydrocision device.
The site was confirmed with the patient and marked with a marking pen. History and physical, as well as informed consent, were reviewed and placed in the chart. The point of maximal tenderness was identified and marked. The patient was then transported by nursing staff to the procedure room. Time-out was held to confirm the [right/left] upper extremity as the correct operative site.
The anatomy was identified, and the diseased tissue was visualized using real-time ultrasound guidance. The area was prepped using chloraprep and anesthetized with 15 cc of 1% lidocaine with epinephrine using a 27 gauge 1.5 in needle under ultrasound guidance.
An #11 blade was used to make an incision over the level of the affected tendon for access to the target tissue. A sterile sleeve was placed over the ultrasound transducer.
To treat the diseased tendon, the surgical instrument was introduced through the incision and advanced to the pathologic tendon under ultrasound guidance. Once the tip of the instrument was confirmed within the pathologic tissue, the device was activated and the diseased/pathologic portions of the common extensor tendon were resected and removed.
In addition, several fenestrating passes were made to the overlying common extensor tendon to further address areas of tendinosis. Significant striations of calcification were noted within the tendon origin at the lateral epicondyle region, and these calcifications were debrided and removed.
Under continued ultrasound guidance, the device was moved back and forth and rotated to target all areas of diseased tissue until satisfactory changes were observed on ultrasound imaging.
Following the procedure, Dermabond was placed over the incision followed by a Tegaderm dressing. 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.