Physician billed debridement x 3. I am puzzled. It does seem to be debridement, especially since there are no margins listed. Would this be correct. I don't bill biopsy/debridement that much.
Thanks in advance.
DX: RT Hand Infection previously
PROCEDURE: Excisonal biopsies x 3 of his right hand
We started with the #1. The #1 site was over the 5th metacarpal mid shaft area. An incision was made longitudinally through the skin. Blunt dissection was done of subcutaneous tissue. Local branches of nerves and tendons were identified and protected all times. Just deep to the extensor tendons in this location over the 4th and 5th metacarpals, as a pocket of granulomatous tissue. It was sent as samples as was cultured and with rongeur, alll of that was derided. Copious irrigation was done and this was covered up. A second incision was made over the what we called the #2 biopsy site and incision was made over the dorsal aspect in line with very much proximal area of the 3rd metacarpal. Distal through skin, a small portion of the skin was excised from the scar and then just below that, there was some slightly brown tissue, but was not terrible and this also derided preserving the local branches of nerves and tendons. At this location, all devitalized tissue was derided was normal architecture was preserved and copious irrigation was done. A third area was really over the more distal area between the 2nd and 3rd metacarpal. There was previous incision, again, small scar was excised, in this location, on the unlar side of #3, we found a small pocket of slightly brown tissue that was adjacent to his fascia. The fascia was excised preserving the tendons and the nerves. We sent a sample as well as culture was taken from this area.
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