ortho1991
Guru
Hi All, Need opinions on this. 64721 and 64719 billed out on the same claim. I believe I read if note states separate incision ok to bill 64721 and 64719,59. Here is that part of the op note.
Attention was directed towards the ulnar nerve release at the wrist first, where Brunner incisions were made over the ulnar neurovascular bundle extending curvilinear towards Guyon's canal. Bleeding was controlled with bipolar cautery. I elevated full-thickness flaps. I identified the FCU and retracted it ulnarly, identified the ulnar neurovascular bundle and released the ulnar nerve from its investing fascia. There was substantial thickened distal forearm fascia that I had to dissect through. I took it through the hypothenar bands, which were very tight and upon releasing it, gave the ulnar nerve excellent freedom in the wound. I dissected down to the level of the trifurcation and released the ulnar nerve fully.
I now performed the carpal tunnel release with an incision line with 4/3 was created, bleeding was controlled with bipolar cautery. The palmar fascia was incised. The APB was brushed aside and transverse carpal ligament was identified and fully released distally at the level of the superficial palmar arch all the way through its proximal confluence with antebrachial fascia. A full release was obtained. The TCL was thickened. The nerve was flattened, but there was no significant tenosynovitis
Please any help with this will be apprecited.
Thank you
Attention was directed towards the ulnar nerve release at the wrist first, where Brunner incisions were made over the ulnar neurovascular bundle extending curvilinear towards Guyon's canal. Bleeding was controlled with bipolar cautery. I elevated full-thickness flaps. I identified the FCU and retracted it ulnarly, identified the ulnar neurovascular bundle and released the ulnar nerve from its investing fascia. There was substantial thickened distal forearm fascia that I had to dissect through. I took it through the hypothenar bands, which were very tight and upon releasing it, gave the ulnar nerve excellent freedom in the wound. I dissected down to the level of the trifurcation and released the ulnar nerve fully.
I now performed the carpal tunnel release with an incision line with 4/3 was created, bleeding was controlled with bipolar cautery. The palmar fascia was incised. The APB was brushed aside and transverse carpal ligament was identified and fully released distally at the level of the superficial palmar arch all the way through its proximal confluence with antebrachial fascia. A full release was obtained. The TCL was thickened. The nerve was flattened, but there was no significant tenosynovitis
Please any help with this will be apprecited.
Thank you