I am afraid to say that both are NOT appropriate for these procedures:
Procedures done are : Excision Vicker's ligament + Epiphysiolysis of fused physis with fat graft . We have to go to assign codes for these .
NOT EPIPHYSIAL ARREST WHICH IS EPIPHYSIODESIS (FUSION) OR CLIPPING OR STAPLING( 25450).
25337- for Reconstruction for UNSTABLE DISTAL ULNAR OR [B]RADIOULNAR JOINT[/B
This has nothing to do with the Vickers ligament release or excision.]
I would go for the code sets option:
1.a 25107:Arthrotomy distal radioulnar joint including repair of triangular cartilage ,complex. - which he has performed and documented.
1b.25076 excision tumor, soft tissue of forearm and or wrist deep - for excision release of volar ligament (sift tissue) [ I select this for vickers ligament excision because the description says excision ........., soft tissue of wrist deep.
2. 25332- Wrist arthroplasty with interposition with or without internal or external fixation. ( instead of 1a)
Because : The surgeon has performed surgery for changing the bony anatomy of the metaphysis of radius (distal radius) or salvage procedure of the distal radius which is the main stay of procedure for madelung deformity for a girl (13years old) of this category of skeletal maturity (ie skeletal immaturity is not found).
2. 25107:Arthrotomy distal radioulnar joint including repair of triangular cartilage ,complex. - which he has performed and documented.-alone
25076 excision tumor, soft tissue of forearm and or wrist deep - for excision release of volar ligament (soft tissue) [ I select this for vickers ligament excision because the description says excision ........., soft tissue of wrist deep.
Since we do not have a CPT code in its name(Vickers ligament) , I thought it is ideal to go for soft tissue excision.
The following is only a moment to ponder:
I did have a different school of though for this Vickers ligament whether this can be familied into the transverse carpal ligament being a part of that an dits relation to median nerve and the symptom. the idea of release is to release the nerve pain too. if can be accepted then we could think of the code 64721 , because in the page 129 , parenthesis notes of 29848 gives for open procedure 64721.
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