maljdcpc
Networker
Provider wants to bill 11044 for debridement but not sure if that is correct code and he doesn't report surface area. I got 11012 through 3M however not open fracture so I don't think that is right code either? Any help would be greatly appreciated
POSTOPERATIVE DIAGNOSES:
1. Left third metacarpophalangeal dorsal dislocation, irreducible.
2. Complex wound, left palm.
PROCEDURES PERFORMED:
1. Open reduction of left third metacarpophalangeal joint dislocation.
2. Repair of left third metacarpophalangeal joint volar plate.
3. Irrigation and debridement of complex wound, left hand.
Attention was turned to the left hand. The transverse wound was opened. This
was a deep wound extending to the MCP joints. There was no exposed bone
through the initial evaluation and exploration. The wound was copiously
irrigated. There was no foreign material or debris appreciated. Nonviable
skin edges were debrided. Skin, subcutaneous tissue, tendon and bone were
all copiously irrigated and debrided where necessary. The third
metacarpophalangeal joint was further evaluated. There was an interposition
of the volar plate making the joint irreducible. There was a tear involving
of the volar plate and this was slightly extended to allow for access to the
joint. Once the tissue was removed, the joint was reduced and fluoroscopic
imaging confirmed a concentric reduction. There was no associated fracture
appreciated. The joint was laxed, but had no gross instability at this
point. There was a significant tear involving the volar plate and this was
repaired with Vicryl suture. This helped to stabilize the
metacarpophalangeal joint from any additional hyperextension. It should be
noted that the A1 pulley was released to allow for access to the
metacarpophalangeal joint as the flexor tendons were mobilized ulnarly. The
flexor tendons were intact as were the neurovascular bundles. Following
repair of the volar plate. The hand was taken through a gentle range of
motion. The third metacarpophalangeal joint was noted to be stable. No other
pathology was appreciated. Final irrigation was performed. The wound was
explored once again. No other pathology was appreciated. The tourniquet was
deflated. Hemostasis was achieved. Brisk capillary refills appreciated in
all digits. The wound was then closed in a tension-free fashion. A sterile
postoperative dressing with volar splint was applied.
POSTOPERATIVE DIAGNOSES:
1. Left third metacarpophalangeal dorsal dislocation, irreducible.
2. Complex wound, left palm.
PROCEDURES PERFORMED:
1. Open reduction of left third metacarpophalangeal joint dislocation.
2. Repair of left third metacarpophalangeal joint volar plate.
3. Irrigation and debridement of complex wound, left hand.
Attention was turned to the left hand. The transverse wound was opened. This
was a deep wound extending to the MCP joints. There was no exposed bone
through the initial evaluation and exploration. The wound was copiously
irrigated. There was no foreign material or debris appreciated. Nonviable
skin edges were debrided. Skin, subcutaneous tissue, tendon and bone were
all copiously irrigated and debrided where necessary. The third
metacarpophalangeal joint was further evaluated. There was an interposition
of the volar plate making the joint irreducible. There was a tear involving
of the volar plate and this was slightly extended to allow for access to the
joint. Once the tissue was removed, the joint was reduced and fluoroscopic
imaging confirmed a concentric reduction. There was no associated fracture
appreciated. The joint was laxed, but had no gross instability at this
point. There was a significant tear involving the volar plate and this was
repaired with Vicryl suture. This helped to stabilize the
metacarpophalangeal joint from any additional hyperextension. It should be
noted that the A1 pulley was released to allow for access to the
metacarpophalangeal joint as the flexor tendons were mobilized ulnarly. The
flexor tendons were intact as were the neurovascular bundles. Following
repair of the volar plate. The hand was taken through a gentle range of
motion. The third metacarpophalangeal joint was noted to be stable. No other
pathology was appreciated. Final irrigation was performed. The wound was
explored once again. No other pathology was appreciated. The tourniquet was
deflated. Hemostasis was achieved. Brisk capillary refills appreciated in
all digits. The wound was then closed in a tension-free fashion. A sterile
postoperative dressing with volar splint was applied.