Hello everyone, today is not a good coding day for me, i have about 3-4 op reports that i can't figure out, here is one of them,

Brief Clinical History:

patient sustained debiliating burn to her right upper extremity, she was admitted to ------Hospital and had immediate emergency surgery with debridement and then attempt with agressive hydrotherapy to see if there will be a chance for healing without skin grafting.

Conservative treatment did not work. The patient required a debridement of the right upper extremity and skin grafting. This excision and skin grafting procedure was deon at ----------Medical Center. The patient is now more than 10 days post up and she is going under general anesthesia have the dressing removed. All sutures and staples are to be reoved and manipulation under anesthesia of all the stiffened joints to facilitate and accelerate her recovery.

The patient was placed on the operating table. General anesthesia was administered. Once being done, the patient had the donor site on the right thigh meticulously removed smeared with Xeroform gauze, bacitracin, and then we wrapped with Kerlix. The right thigh did heal prperly. The patient then had attention directed to the right hand and wrist. The patient had the dressing first completely removed. When it was completely removed, the patient then had the multiple staples and sutures then removed from the right hand, which were over 500. the wrist was very stiffened and this was manipulated throughout range of motion, supinated and pronated. The thumb, index, middle, ring and little finger were manipulated under anesthesia in all ranges of the motion. then the patient had on the radial and the ulnar aspect throughout MP, PIP and DIP joints of the index, middle, ring, and little finger a soultion of Celestone and Marcaine injected equally 0.2/10cc as well as a DIP, MP, and CMC joint of the thumb. The wrist was also injected with the similar solution and diluation was 6mg of Celestone per 1cc of Marcaine.

maybe 26340 F6
26340 F7
26340 F8
26340 F9
26340 F5
20605-RT (wrist)
20610 for each joint (MP, PIP and DIP of each finger & DIP, MP & CMC
of thumb)

Also the dr. says i should bill the MUA (26340 for each joint , MP, DIP and PIP of each finger also ) example 26340 F6 x3 for each????

thank you