# I&D DEBRIDEMENT/tendon repair



## nabernhardt (Jul 9, 2012)

needing help with this please.  Came up with 26410 x 9 so far?
He had grease in the bones of the 2nd, 3rd, and 4th metacarpal heads without dislocation at the CMC joint. I débrided the grease, thoroughly irrigated it, prepared the edges of the complex wound, and identified the tendons. The EIP was lacerated beyond repair and the common extensor to the pinky was also missing a significant chunk, but I was able to primarily repair using cruciate 4-stranded strips for each repair with a running fiber Prolene on top for all the nine tendons listed above. I was able to close the wound with 3-0 nylon without excessive gap, but the wrist extended into the safe position. I left the dorsal, a small ulnar, and radial-sided portions of the wound open to
minimize excessive tension. Bulky dressing was applied in a sterile position and I did put the pulse ox on all of his fingers with a good waveform and 96-97% saturation.

Irrigation, debridement, and complex closure of deep 17 x 9 cm wound with
repair of nine extensor tendons, including the common extensors to the index, ring, and middle fingers, the EDQ, the ECU, the ECRB, the ECRL, and the EPL. Also, irrigation and debridement of open fractures x4 with debridement of open arthrotomy.

thanks


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## nabernhardt (Jul 15, 2012)

does anyone have a suggestion please?


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## mitchellde (Jul 15, 2012)

Is there more to this note?  which hand?  he also states nine tendons in one area but describes only eight. you do not bill these codes with units, but he stats open fractures but not where specifically.  Either the note requires augmentation for greater specificity or there is something you left out that is needed.


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## nabernhardt (Jul 15, 2012)

thank you.  Unfortunately this is all I have for the note which is not very much.
Could you help me or kind of lead me in the right direction of what I need to have the physician document in regards to this procedure note please?  thanks


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