Need help with this food procedure. Feel like I'm missing something. I thought code 28120 looked good but feel like I'm missing something on the extensor brevis belly muscle part. As this is my first foot coding, I thought I better get some help. Thanks.
PREOPERATIVE DIAGNOSIS: Symptomatic calcaneonavicular coalition of the right foot.
POSTOPERATIVE DIGNOSIS: Symptomatic calcaneonavicular coalition of the right foot.
PROCEDURE PERFORMED: Excision of the calcaneonavicular coalition of the right foot with interposition of the extensor brevis muscle belly and application of a short leg splint.
DESCRIPTION OF THE OPERATION: The patient was prepped and draped in the routine sterile fashion after adequate regional anesthesia was obtained. An oblique incision was made from the base of the fourth metatarsal to the base of the fibula. We incised all the tissues down to the extensor brevis. The extensor brevis was then identified proximally and then reflected distally. We then identified the sinus tarsi area and resected part of the tissues inside this area until we got down to the calcaneal anterior process and then we identified the navicular. Using the osteotome we resected part of the calcaneus and part of the navicular and squared this off nicely. We then smoothed the edges with a rasp and then with bone wax. We put a general Maxon suture and pulled the extensor brevis into the defect. Once all of this was completed, we then closed the subcutaneous tissues with a running 2-0 Vicryl suture. The skin was closed with a running horizontal mattress nylon suture. The patient was put in a bulky dressing and a short leg splint and transported to the recovery room in stable postoperative condition.
Donna Struve CPC
NW Iowa Bone Joint Sports Surgeons