#1 Yesterday, 09:09 AM
Guru Join Date: Apr 2007
Posts: 224



ESCRIPTION OF PROCEDURE:After verbal consent was obtained, the patient was brought to the operating room suite, and placed on the table in supine position. A pause was undertaken to confirm the patient as well as location of surgery. Once this was confirmed, an adequate level of sedation was achieved, and a field block was administered using a total of 10 cc of a one-to-one mixture of lidocaine and bupivacaine. While this was setting up, the hand and forearm were prepped with chlorhexidine and alcohol and draped in the normal sterile fashion. Manual exsanguination was performed, and a forearm tourniquet was inflated to 250 mmHg. An axial incision was made over the A1 pulley regions, and tenotomy scissors were used to dissect down to the flexor tendon sheath. Radial and ulnar digital neurovascular bundles were identified and protected from harm's way. An incision was made over the entire length of the A1 pulley, exposing the underlying tendons. Along both the index and middle flexor tendon sheath, a small flexor retinacular ganglion mass was encountered, consistent with a cyst. These were excised, and will be sent together to pathology for further analysis. The index finger flexor tendons showed a fair amount of synovitis, which was gently debrided. The incisions were then closed using a series of interrupted 4-0 nylon horizontal mattress sutures. A dressing was applied, consisting of Xeroform, dry gauze, and a Coban wrap. Tourniquet was then released with a total tourniquet time of 12 minutes. The fingers immediately pinked up. The patient was awakened from anesthesia, transferred to the hospital but, and taken to the postanesthesia care unit in stable condition.

per AAOS what is not included in 26160
insertion removal or exchange of nonbiodegradable drug
subsequent splinting
Tenolysis or tenosynovectomy
excision of osteophyte
incision or resection of flexor tendon sheath distant site 26055

so I get

26055 F1,26055 59F2,26160 F1,26160 59 F2 (59 for seperate incision/EXCISION. I would like to have anothers opinion.) this is a commercial carrier