# Bone biopsy proximal phalanx toe



## seslinger (Feb 2, 2009)

A doctor did a "bone biopsy of the proximal portion of the lateral aspect of the phalanx" and the office is using 20225 but would 20220 be better to use?

thank you for any imput


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## mbort (Feb 2, 2009)

seslinger said:


> A doctor did a "bone biopsy of the proximal portion of the lateral aspect of the phalanx" and the office is using 20225 but would 20220 be better to use?
> 
> thank you for any imput




I'm thinking neither..of course I dont have the documentation either.

Please look at 26110 to see if it meets your needs 

Mary, CPC,COSC


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## seslinger (Feb 2, 2009)

It was of the toe said possible tophi - path came back "synovial & fibroadipose tissue with slight chronic inflammation, osteomyelitis cannot be excluded."


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## mbort (Feb 2, 2009)

seslinger said:


> It was of the toe said possible tophi - path came back "synovial & fibroadipose tissue with slight chronic inflammation, osteomyelitis cannot be excluded."



sorry..I should no better than to assume body parts by now!!

Can you tell me how he did the bone biopsy--what was the technique used, etc?  Can you post the note?


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## seslinger (Feb 3, 2009)

It doesnot say exactly the technique it states "The head was reshaped once again with the bur and the bone biopsy was performed with a rongeur on the proximal portion of the lateral aspect of the phalanx. This was sent for gross examination.  During dissection down into the capsule there continued to be a white cottage cheese likely flaky substance that appeared around the tissue.  These flakes were tried to be removed from the area.  They were very small, was unable to tell what they looked like.  It almost looks like a gouty tophi."


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## mbort (Feb 6, 2009)

I'm looking at 28124 but I think I would check with the doc first to get more clarification.


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## magnolia1 (Feb 6, 2009)

What about 20240?


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## mbort (Feb 9, 2009)

magnolia1 said:


> What about 20240?



I saw that too, the reason I chose the 28124 was because he did more than a biopsy by reshaping the bone and then using what he shaved off to send to pathology (that was my interpretation).  Am I off-base?


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## magnolia1 (Feb 9, 2009)

That also kind of makes sense Mary.......

When I was reading the description procedure, I did think that it sounded like more than a biopsy.


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