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Open lysis of adhesions of right total knee arthroplasty

  1. #1
    Default Open lysis of adhesions of right total knee arthroplasty
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    I am having difficulties finding the correct codes for this surgery. I would appreciate any help I can get.

    1. Removal of hardware from right knee.
    2. Open lysis of adhesions of right total knee arthroplasty.
    3. Manipulation under anesthesia right knee.

    PROCEDURE: The patient was identified in the preoperative
    surgical area. Her right knee was marked with the surgeon's
    initials. She was transferred to the operative suite by
    Anesthesia. She underwent successful general endotracheal
    anesthesia and was placed supine on the operating table. A
    time-out was done to confirm the operative site. Consent was
    confirmed. Her right leg was prepped and draped in the usual
    sterile fashion. She did receive a dose of preoperative
    antibiotics. Using the previous incision sharp dissection was
    carried down to identify the retinaculum. I did perform a medial
    patellar arthrotomy upon entering the knee. No gross purulence or
    excessive fluid was encountered. There was heavy dense scar
    tissue throughout the knee. The knee could only be ranged 30
    degrees. We were able to identify the wire through a separate
    lateral patellar arthrotomy. The knot was identified and the wire
    was cut and easily removed. C-arm images confirmed that the
    entire wire was removed in its entirety. Following removal of the
    wire there was an immediate increase in range of motion to
    approximately 60 degrees. Following this, manipulation under
    anesthesia was performed and we were able to obtain flexion to
    113 degrees with extension to 3 degrees. She did appear to have
    appropriate stability of varus and valgus stress and her patella
    did track normally. Following this we completed lysis of
    adhesions and performed a synovectomy. We irrigated the
    intra-articular portion of the knee with 3 liters of normal
    saline using a pulse lavage system. Following this we closed the
    retinacular with a PDS suture, subcutaneous tissues with Vicryl,
    and the skin with staples. She was placed in standard sterile
    dressings and successfully extubated by Anesthesia. She was
    transferred to the postoperative recovery area in stable

  2. #2
    I would code 27331.

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