Orthopedic Coding Alert

Question Is it right to code 15852 if the surgeon planned a repeat irrigation debridement on right index finger proximal phalanx cat bite wound, and repeat irrigation debridement right index finger metacarpal phalangeal joint? The wound was thoroughly irrigated with antibiotic solution along with the extensor tendon and subcutaneous tissues as well as repeat irrigation of the metacarpal phalangeal joint. The wound was packed open with quarter inch iodoform gauze and a well-padded shortarm fiberglass splint was applied. Or should I instead code 11044-58, 26080-58 and 29125?

Georgia Subscriber

Answer For the situation here, 11044 (Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less) is better as compared to 26080 (Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each) as the latter involves arthrotomy. Since it is two joints, the code becomes 11044 x2. In addition to 11044 x2, append modifier -51 (Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or.......). Alternatively, one may code 26075 (Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each) if the approach includes an arthrotomy and append modifier -58 (Staged or related procedure or service by the same physician during the postoperative period.....). The splint application is inclusive. Code 15852 (Dressing change (for other than burns) under anesthesia (other than local)) is not appropriate for this condition.