Presentation: Pt has large open wound to proximal tibia from gunshot wound. Literally, the patient has only a small strip of bone left over about a 2 in. section. External fixation was put in place a few days prior. Dr. has used a combination of bone morphogenic protein, DBM, cancellous strips, bone pieces obtained during debridment, and bone marrow to make a 'slurry'. Then using a large piece of bone morphogenic protein sheet, he lined the cavity and packed it with the mixture. He used a second BMP sheet to cover that, essentially creating a sleeve consisting of shell of BMP sheet with the bone graft mixture inside. Other than the previously mentioned external fixation, no other fixation is being utilized.

Has anyone coded anything like this before? We are leaning towards using an unlisted code.