lewisbr
Guest
Hi to all, question my ortho physician documented he did a Achilles tendon debridement and repair along with lengthening the tendon at the same session. To my knowledge the debridement is included in the repair? needs clarification.The diagnosis is haglunds deformity of heel. I was looking at using procedure code 27685 (Lengthening or shortening of tendon, leg or ankle single tendon (separate procedure) along with 28118 (Ostectomy, calcaneus)? because the physician indicated he had to take the tendon off the bone in order to repair and debride the stump. Any suggestions?
op report: An Incision was made over the Achilles tendon on the medical side and carried across the calcaneus at the Achilles insertion. The flap was elevated from the Achilles tendon, taking care to make that as thick as possible. A retention suture was placed to hold the flap in place. The Achilles tendon was taken off the bone w/a 15 blade. There was some ossicles in the tendon, which were excised. The retro Achilles burse was inflamed. The dorsal portion of the calcaneal tuberosity was removed with a oscillating saw. This was then contoured with a rongeur and two suture anchors were placed to the Achilles insertion. The distal stump of the Achilles was debrided to healthy margin. The 4 sutures of the suture anchors were brought laterally and secured with a pushlock within the calcaneus. A limb from the medical and lateral sutures were then brought proximally in a bunnell-type suture and tied. An incision was then made at the musculotendinous junction of the seleus. Dissection was carried bluntly down to the tendon, fractional lengthening was then performed with a 10 blade.
op report: An Incision was made over the Achilles tendon on the medical side and carried across the calcaneus at the Achilles insertion. The flap was elevated from the Achilles tendon, taking care to make that as thick as possible. A retention suture was placed to hold the flap in place. The Achilles tendon was taken off the bone w/a 15 blade. There was some ossicles in the tendon, which were excised. The retro Achilles burse was inflamed. The dorsal portion of the calcaneal tuberosity was removed with a oscillating saw. This was then contoured with a rongeur and two suture anchors were placed to the Achilles insertion. The distal stump of the Achilles was debrided to healthy margin. The 4 sutures of the suture anchors were brought laterally and secured with a pushlock within the calcaneus. A limb from the medical and lateral sutures were then brought proximally in a bunnell-type suture and tied. An incision was then made at the musculotendinous junction of the seleus. Dissection was carried bluntly down to the tendon, fractional lengthening was then performed with a 10 blade.