CRC CPC
Guru
HELP!! This seems like so much more to me than a 29871 is there also a debridement code I can use? I'm wondering if I looked at this too long. Any suggestions would be appreciated 
Septic right knee.
PROCEDURE:
Extensive irrigation and extensive debridement, right knee. Culture
was obtained.
FINDINGS:
Significant purulence and inflammatory tissue noted.
INDICATIONS:
Patient was placed on the operating room table in the supine
position. Following successful anesthesia, a tourniquet was placed
on the upper right thigh but not inflated. Right lower extremity
was then prepped and draped in the usual sterile fashion. Patient's
previous arthroscopy portals were utilized. An incision was taken
sharply through skin and subcutaneous tissue. The scope was
initially placed in the anterolateral portal but then alternated as
necessary for visualization. The shaver was placed in the other of
portal throughout the procedure. A significant amount of purulent
fluid was initially encountered and drained. The irrigation was
performed with 9 liters of normal saline fluid, and significant
inflammatory synovitis was also encountered and debrided. A moderate
degree of arthrosis, grade 2/3 degenerative changes was seen in all
compartments. The medial and lateral menisci were intact. They
were probed and they were not unstable. The ACL was significantly
frayed and the most anterior and medial aspect was torn, this was
debrided. The PCL was probed and was felt to be intact although not
visualized. The gutters were noted to have synovitic tissue but no
loose
bodies were encountered. Following thorough irrigation a drain was
placed inside the knee joint and brought out superolaterally, and the
excess fluid was drained and all equipment were removed. The portals
were reapproximated with 2- 0 nylon approximating skin and subcutaneous
tissues. The dressings were applied which included, 4x4s, ABD pads,
sterile Webril, and an Ace bandage to include the entire right lower
extremity. The patient was then
awakened, transferred to her bed and taken to recovery in
satisfactory condition. Her procedures were free of complications.
______________________________
Septic right knee.
PROCEDURE:
Extensive irrigation and extensive debridement, right knee. Culture
was obtained.
FINDINGS:
Significant purulence and inflammatory tissue noted.
INDICATIONS:
Patient was placed on the operating room table in the supine
position. Following successful anesthesia, a tourniquet was placed
on the upper right thigh but not inflated. Right lower extremity
was then prepped and draped in the usual sterile fashion. Patient's
previous arthroscopy portals were utilized. An incision was taken
sharply through skin and subcutaneous tissue. The scope was
initially placed in the anterolateral portal but then alternated as
necessary for visualization. The shaver was placed in the other of
portal throughout the procedure. A significant amount of purulent
fluid was initially encountered and drained. The irrigation was
performed with 9 liters of normal saline fluid, and significant
inflammatory synovitis was also encountered and debrided. A moderate
degree of arthrosis, grade 2/3 degenerative changes was seen in all
compartments. The medial and lateral menisci were intact. They
were probed and they were not unstable. The ACL was significantly
frayed and the most anterior and medial aspect was torn, this was
debrided. The PCL was probed and was felt to be intact although not
visualized. The gutters were noted to have synovitic tissue but no
loose
bodies were encountered. Following thorough irrigation a drain was
placed inside the knee joint and brought out superolaterally, and the
excess fluid was drained and all equipment were removed. The portals
were reapproximated with 2- 0 nylon approximating skin and subcutaneous
tissues. The dressings were applied which included, 4x4s, ABD pads,
sterile Webril, and an Ace bandage to include the entire right lower
extremity. The patient was then
awakened, transferred to her bed and taken to recovery in
satisfactory condition. Her procedures were free of complications.
______________________________
