Any ideas on a code or codes to use for this?
Heres the meat of the op note. Thanks for any help!
A longitudinal incision was made on the anterior edge of the Achilles tendon. It was carried down the subcutaneous tissues. Care was taken not to violate the subcutaneous nerve structures. The anterior edge of the tendon was then peeled off the calcaneus, and I did this from lateral to medial all the way across the length of the calcaneus, and there was a deformed tubercle of the calcaneus with cauliflower looking appearance. At this point, I used the Freer elevator to elevate the tendon away from the bone and using the elevator as a protective device, I then used a saw to cut the tubercle of the calcaneus away.
Having completed this, I now used a reciprocal rasp to smooth, taper, and balance the cut that was made.
At this point, the tendon was palpated. There were multiple calcifications in the tendon, and I shelled these out leaving the tendon essentially intact.
Having completed this, I then irrigated copiously. I closed in layers utilizing 2-0 Vicryl and 3-0 PDS sutures. I injected with Marcaine for postoperative pain management, a bulky dressing was applied to the extremity, placed the patient in 90 degrees in the boot, and the tourniquet was deflated prior to this, 35 minutes.
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