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Help !ASAP! foot codes

  1. #1
    Default Help !ASAP! foot codes
    Medical Coding Books
    1. Left, neurolysis/decompression of the 3rd intermetatarsal nerve-endoscopic
    2. left, neurolysis/decompression of the 2nd intermetatarsal nerve-endoscopic

    The code used was 64704.

    please advise if this correct.

    Thank in advance.

  2. Default 64704
    Depends on which nerves...

    Common Peroneal Nerve 64708
    Deep Peroneal Nerve 64722
    Posterior Tibial Nerve 28035

    If nerves other than these, let me know...My Physician does this kind of surgery.
    Hope this helps!

  3. #3
    Default Foot help
    Here is the op report

    the interspace was then marked with topographical markings, to assure the proper cannular placement. a longitiudinal line was made on the dorsal aspect of the interspace between the respective between the respective metatarsals from the proximal to distal. the metatarsal heads were then palpated and small markings for the dorsal incisions were placed approximately 2 and a half cm proximal to the level of the metatarsal phalangeal joints. using a number 15 blade a small 4mm, 2 longitudinal incisions were made on the dorsal aspect of the interspaces, as delineated by the markings. careful attention was made not to transect tissue deeper than the dermis. protection of the superficial peroneal nerve branches was then achieved using blunt dissection with stephen tenotomy scissors to make the portal deeper between the respective metatarsals. at this time the metatarsal retractor was then placed into the repective portal, gradual retraction was placed on the instrument. this caused tension in the transverse manner of the deep transverse intemetatarsal ligament. Between the dorsal and plantar neurovascular structures, in the 2nd and 3rd web spaces, incisions were made just subdermal, with careful attention to protect the tiny dermal nerve branches. the incisions was deepended with blunt dissection using the tenotomy scissors, down to the level of the inferior aspect of the transverse intermetatarsal ligaments. the elevator was then used to make a channel underneath the transverse intermetatarsal ligament ofr placement of the cannula, with two finger pencil grip technique.this step as well as the transection of the deep intermetatarsal ligament were performed independantly and not concurrently. it should be noted that the mimimal resistance on the instrument identified the proper tissue plane during its placement. once the evelvator was placed inferior to the transverse intermetatarsal ligament, dorsal pressure was then placed on the instrument t feel unforgiving rigidity of the transverse intermetatarsal ligament. the next procedure was placement on the oval cannula in the same positions, beneath the transverse intermetatarsal ligament, that was just achieved with the same elevator. the obturator was removed from the visualization on the monitor of the proximal border was identified, and could be differentiated from the soft tissue proximal to it. introducing an angled hook blade in the same cannula, the transverse intermetatarsal ligament was then transected from proximal to distal. Separated ligamentous edges were identified endoscope, and they were noted to separate upon placement of further retraction onthe intermetatarsal retractor. the obturator was replaced into the cannula and the entire obturator/cannula instrumentation was removed from the interspace. the elevator was reintroduced intothe distal portion incision, and it was noted not to have any dorsal resistance against it from the transected transverse intermetatarsal ligament. this was performed with exactness to 2nd and 3rd intermetatarsal spaces. 5-0 nylon skin sutres were placed into the incision to close the, and .5% marcaine plain was infiltrated into the interspace for long lasting anesthesia. 0.5 cc dexamethasone was infiltrated intothe surgical site for anti-inflammatory effect. a compressive cause dressing was placed on the patient, andupon release of the tourniquet and instantaenous hyperemia was noted.

    The cpt code assigned to this op report was 64708 x2
    I am not sure this is the correct code, can someone help?

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