i think Ii have the right codes was wondering how to bill this ?
POSTOPERATIVE DIAGNOSES: 1. Onychogryphosis of the great toe, right and left foot. 2. Onychomycosis of the toes one through five, right and left. 3. Onycholysis of the toes one through five right and left.
OPERATIONS: 1. Matricectomy of the great toe, right and left. 2. Removal of toe nail plate, two to five right and left.
ANESTHESIA: Local MAC.
ESTIMATED BLOOD LOSS: Minimal.
PATHOLOGY: Mycotic and dystrophic nail plates one to five bilateral.
ANTIBIOTICS: 1 gram of Ancef prior to surgery.
FINDINGS: The patient first presented to my office. The patient stated that her nails were bothering her and giving her a great deal of pain and discomfort. The patientâ€™s nail plate was dystrophic and mycotic in nature. The patient stated that most of the problem was that she could not wear shoes. We decided to remove the toenails and to do a matricectomy of the great toes one to five.
PROCEDURE IN DETAIL:
The patient was brought into the operating room and placed in a supine position. Once the patient was placed in a supine position, the patient was given a digital block two to five right and left. Once the digital block was given, it was decided to put an ankle tourniquet, and once the ankle tourniquet was put in, it was decided to prep and drape the foot in a sterile manner. Once that was done, it was decided to exsanguinate the left lower extremity and to remove all nail plates. With the use of a Key elevator, we removed the nail plates one through five by separating them from the nail bed over the both medial and lateral sides and separated the nail bed.
Once that was done and the nail plates were removed, we decided to make an oblique incision on each side of the medial and lateral sides of the nailfold. Then, we took back a part of the nail fold and split back the matrix. Once we split back the matrix, we decided to resect the area to remove the matrix. After we took out an elliptical wedge from the matrix, we decided to suture the proximal, medial, and lateral fold with 3-0 Prolene. In the left foot, the ankle tourniquet was deflated. Now, attention was directed to the right foot. We decided to exsanguinate the right lower extremity. After exsanguinating the right lower extremity, we decided to remove all nail plates one to five. After removal of all nail plates one to five, attention was then directed to the first great toe. We separated the nail plate from the nail bed _____ matrix. Then, we made an incision in the medial and lateral folds obliquely and separated the proximal nailfold, in which we removed a part of the tissue. Once we removed a part of that tissue and scraped with a curette, we decided to remove a part of the proximal nailfold and suture the nail bed medial and lateral borders with 3-0 Prolene. The ankle tourniquet was deflated. A dry, sterile dressing was applied to the right and left foot. Once the ankle tourniquet was deflated, _____ was intact. The patient tolerated the procedure and anesthesia well. The patient was transferred from the operating room to Recovery.
Would I BILL IT LIKE THIS ?
then for the matricectomy of great toe left and right
WOULD THIS BE CORRECT ?
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