# Ulnar decompression?



## BFAITHFUL (Nov 22, 2011)

I'm thinking just billing 64718-RT as the medial epicondylectomy according to AAOS and epineurolysis is inclusive.    Not sure about the debridement though?
What you guys think?


*DX*: Medial epicondylitis of right elbow

*Procedure*: Debridement of flexor tendon attachment to the medial epicondyle, partial medial epicondylectomy, decompression of the ulnar nerve with epineurolysis of the ulnar nerve of right elbow.

The medial epicondyle was marked with the elbow flexed posterior to the medial epicondyle.  A small curved incision was made approximately 2cm proximal and distal.  Under loop magnification, skin flaps were mobilized.  Blood vessels were electrocauterized.  The ulnar nerve was identified under loop magnification, was decompressed and an epineurolysis was also performed all the way out from the arcade of Struthers down to the flexor tendons.  After this was accomplished, hyperemia from the necrotic tissue was found in the epicondyle where an an incisioin was made.  This was retracted.  The scar tissue was removed and the epicondyle was roughened with a roungeur and a rasp.  The flexor tendon was closed with 3-0 vicryl suture.  The low transpoition of the ulnar nerve was made.  closed then described.

Thanks!!!


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## BFAITHFUL (Nov 23, 2011)

any takers on this one??  thanks


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## johnmeyer (Nov 27, 2011)

The only debridement codes for the elbow that I could find are 24358 and 24359. I'd use 24358 from the procedure you posted.


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