# Painful ossicle thumb



## sxcoder05 (Oct 8, 2009)

Need Help.  How would you code this?  


Excision of ossicle from extensor tendon left thumb. 

DESCRIPTION OF PROCEDURE:   The patient was brought to the operating room and placed supine on the operating room table. Following induction of  regional anesthesia, the patient's left upper extremity was prepped and sterily draped in the usual meticulous manner. The tourniquet was inflated to 250 mm of Mercury after exsanguinating the limb with an Ace wrap. 

An incision was made starting at the ulnar corner of the nail fold of the thumb extending proximally to the extensor crease and then obliquely ulnarward for another 1.5cm. The skin flap was elevated over the skin and subcutaneous tissues leaving the extensor mechanism exposed. The bony ossicle was noted to be intrasubstance in the extensor tendon and involved about half the width of the extensor tendon. Using sharp dissection, I was able to remove the ossicle without difficulty and the mass was sent to the lab as specimen. 

The extensor tendon was repaired with figure of 8 stitches of 3.0 Vicryl. This resulted in a good repair. I could flex her DIP joint to about 40 degrees before there was undue tension on the sutures and there was full extension in the resting state.


----------

