Voar plate release, Hand surgery
"Volar aspect of finger approached first via Brunner incision over PIP joint, carried down through subcutaneous layer...flexor sheath identified and entered in the area of cruciate pulleys. Flexor tendons identified and retracted, volar plate released along with checkrein at the ligaments, finger then manipulated into extended position at PIP, wire driven in oblique fashion across joint with joint held in extension. Pin clipped to skin surface, attention turned to extensor surface, incision made over PIP joint, carried through subcutaneous layer, extensor mechanism visualized and there appeared to be disruption of central slip, central slip was mobilized and advanced distally, intrinsic tendons then released from subluxated position and allowed to move dorsalward. Central slip then repaired distally with Ethibond sutrures, vicryl used to close joint capsule and reapproximate intrinsic tendons to their proper location"
Surgeon is coding 26418 and 26525, I am looking at 26418 and 26426, one of my coworkers is saying she doesn't see the 26418 and found info to support 26525 for the volar plate and is suggesting 26426 w/a 52 mod
opinions, help please
Thanks!
"Volar aspect of finger approached first via Brunner incision over PIP joint, carried down through subcutaneous layer...flexor sheath identified and entered in the area of cruciate pulleys. Flexor tendons identified and retracted, volar plate released along with checkrein at the ligaments, finger then manipulated into extended position at PIP, wire driven in oblique fashion across joint with joint held in extension. Pin clipped to skin surface, attention turned to extensor surface, incision made over PIP joint, carried through subcutaneous layer, extensor mechanism visualized and there appeared to be disruption of central slip, central slip was mobilized and advanced distally, intrinsic tendons then released from subluxated position and allowed to move dorsalward. Central slip then repaired distally with Ethibond sutrures, vicryl used to close joint capsule and reapproximate intrinsic tendons to their proper location"
Surgeon is coding 26418 and 26525, I am looking at 26418 and 26426, one of my coworkers is saying she doesn't see the 26418 and found info to support 26525 for the volar plate and is suggesting 26426 w/a 52 mod
opinions, help please
Thanks!
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