Results 1 to 3 of 3

Thread: Plantar Fascia Tenotomy with Topaz

  1. #1

    Default Plantar Fascia Tenotomy with Topaz

    Our Dr performed the following surgery and I'm having difficulty coming up with coding. Has anyone had to bill this out before and what coding did you use? I'm leaning towards unlisted.

    PREOP DIAGNOSIS: RIGHT FOOT CHRONIC RECALCITRANT PLANTAR FASCIITIS
    POSTOP DIAGNOSIS: SAME

    PROCEDURE: RIGHT PLANTAR FASCIA TENOTOMY WITH TOPAZ RADIOFREQUENCY WAND

    ANESTHESIA: GENERAL ET

    INTRODUCTION: Routine preop evaluation revealed no medical contraindication to surgery. The patient and family were consulted at length regarding the relative risks, benefits, and alternatives of the above elected procedure. They understood these risks to include but not be limited to infection, sepsis, osteomyelitis, DVT, PE, stroke, MI, death, nerve or blood vessel damage, RSD, persistent pain, stiffness, requirement for future operative intervention, among others. Understanding all the above risks and that no guarantees were made nor implied, the patient freely consented to proceed.

    OPERATIVE PROCEDURE: Patient was taken to the operating room on 5/2/12 where she was transferred to the OR table and placed in the supine position without event. She was induced under general anesthesia and intubated via the ET route. Prior to initiation of the operative procedure, the American Academy of Orthopedic Surgeons’ timeout protocol was instituted. This assured the patient’s name, the correct extremity, the correct side, the patient’s allergies, their preoperative medications and antibiotics. Following completion of the appropriate timeout and verification of all the above, we proceeded with the operative procedure. The patient received 1 gram Ancef as antibiotic preop prophylaxis in preoperative holding. A tourniquet was placed about the right proximal thigh. All bony prominences were carefully and thoroughly padded. The head and neck were secured in neutral position. The RLE was prepped and draped in the usual sterile fashion. The limb was exsanguinated with a sterile Esmarch bandage. The tourniquet was inflated to 250 mm’s mercury.

    A 2.0 cm longitudinal skin incision was made on the medial plantar aspect of the heel just distal to the plantar fascia origin. Dissection was carried down to the plantar fascia. Visualization of the medial half of the plantar fascia was obtained. Utilizing the Topaz RF wand, 15 perforations were created into the plantar fascia, pie-crusting the plantar fascia in the desired manner. The wound was then irrigated with normal saline and closed with 3-0 Monocryl subcuticular sutures, followed by 3-0 nylon vertical mattress sutures. A bulky compressive dressing was applied with a postop shoe.
    The patient was extubated in the OR and returned to recovery in good condition. There were no noted complications. Sponge, needle and instrument counts were correct at the end of the operative procedure. EBL was minimal. Tourniquet time was 10 minutes.



    Thanks!

  2. #2

    Default topaz

    Sorry, this is a little late.

    The Topaz company recommends that you use the CPT code of the procedure you are doing(ex:achilles tendon repair code)....or use unlisted foot code, Topaz is a tool not a procedure. However I did research some payor policy and found many major commercial payors deem the use of this tool experimental and will not cover it.

    You should check your specific payor policy on the use of this tool.

  3. #3

    Default

    Topaz micro debrider is a tool which utilizes coblation technology to perform a small incision in the fascia and is considered an alternative to the use of standard surgical instruments such as scalpels, low frequency electrocautery etc. Code selection is choosen by procedure performed and specific anatomy involved. The appropriate code should be selected based on the definitvie procedure being performed as described in the code discriptor. - AMA CPT Assitant Sept 2009 Vol 19 Issue 9

Similar Threads

  1. Plantar fascia injection
    By rachell1976 in forum Orthopaedics
    Replies: 2
    Last Post: 08-08-2012, 07:07 AM
  2. Elbow tenotomy with Topaz
    By djhubbard in forum Orthopaedics
    Replies: 0
    Last Post: 01-11-2011, 03:39 PM
  3. Plantar Fascia Hematoma
    By Kevinph84 in forum Podiatry
    Replies: 4
    Last Post: 12-08-2010, 01:04 PM
  4. Anesthesia for Plantar Fascia
    By jsolares in forum Anesthesia
    Replies: 6
    Last Post: 07-01-2009, 09:47 PM
  5. Micro debridement via Topaz Plantar Fascia
    By ginger39 in forum Outpatient Facilities
    Replies: 1
    Last Post: 01-12-2009, 03:17 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.