# Pip joint resection/i&d



## nabernhardt (Dec 29, 2011)

needing others opinions on the following please. I came up with cpt 28024.  Dr wants two codes?
PROCEDURE: I took her to the operating room under a block and sedation and made a
longitudinal incision and opened fracture, resected the joint. It was obviously destroyed and it seemed like the proximal base of the phalanx was going through the medial wound. I irrigated the wound lightly, tacked it together, after the resection and irrigation and culture, with 3-0 Prolene, the dorsal wound. Placed her in a soft dressing and a boot.

also the dx is infected fracture/dislocation of the PIP joint right second toe. Not sure what dx code to use?

any suggestions on the cpt and icd codes please. thanks


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## nabernhardt (Jan 3, 2012)

thinking about could it be cpt code 28160? or 28024?
just trying to figure this out thanks


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## Evelyn Kim (Jan 3, 2012)

was this a fracture or dislocation?  open or closed? was an organizm identified for the infection?

I would recommend 28160 for the documentation as it is.  DX 826.0, 826.1 if it is a fracture and 838.09, 838.19 for a dislocation.  I would query the doctor about fixation of the fx/dislocation.


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## nabernhardt (Jan 4, 2012)

thank you I appreciate your response.  I agree and understand need to find out about the open versus closed and dislocation versus fracture.  Could you please clarify what you mean when saying query about the fixation of fracture? thanks


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## RonMcK3 (Jan 4, 2012)

I think the question is how did the surgeon stabilize the bones. 

You might look at the illustrations for 28292 and 29298 (pp.138 & 140 in CPT 2012 Pro Edition); in both cases, Kirschner wires are used to keep the various bones in the desired relationship to each other. This represents a form of fixation.

So, does the OR (or op note) say anything about fixation?


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## nabernhardt (Jan 4, 2012)

ok I understand thank you for clarifying.
and no what I posted is the whole op note. Doesn't mention anything about fixation.


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## Evelyn Kim (Jan 5, 2012)

How was the fracture stabelized?  if no stablization then only the code for the joint resection can be used.


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