# hand help please



## Justarose (Jun 14, 2009)

seems simple enough ...but I am stuck 

POSTOPERATIVE DIAGNOSES:
1.   Left third palmar mass.
2.   Stenosing tenosynovitis, left third finger.

PROCEDURE PERFORMED:	Left third palmar mass excision with A1 pulley release.

Following successful administration of anesthesia, the left upper extremity was prepped and draped in a clean and sterile fashion after administration of a digital block.  We then held the arm against gravity and insufflated the tourniquet to 250 mmHg, and I used the palmar flexion crease and incorporated that into my incision and under loupe visualization dissected down through the A1 pulley.  I found a large retinacular cyst coming just distal to the A1 pulley.  I found the radial and ulnar digital nerves and protected these.  I then incised the A1 pulley and removed the retinacular cyst.  The FDS tendon was a bit frayed, but overall in good condition.  It was normal in appearance.  I copiously irrigated the wound and closed with 5-0 Prolene stitch.  A bulky dressing with Coban was applied, and the patient was awoken from anesthesia having tolerated the procedure well and was transferred to the recovery room in a stable condition.  Our sponge, instruments, and needle counts were correct at the completion of the procedure. 

I am just really confused on this ...his ops always do that to me .. thanks for your help !


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## lavanyamohan (Jun 14, 2009)

Hello,
Can code 26160 - 727.42
LM


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## jeevapt_09 (Jun 14, 2009)

*icd*

Hi, 
       what doubt about it! its correct link 26160(Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or finger) - 727.42(Ganglion Of Tendon Sheath).


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## rajalakshmir (Jun 15, 2009)

i wil code 26160 , 26055-59 since A1 PULLEY release done for tenosynovitis[triggerfinger] - 26055 and cyst on palmar crease - 26160


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