A 15 blade was used to incise the skin, and a blunt clamp was used to dissect down to the radiocarpal joint. Blunt trocar was then used to enter the joint, and the scope was placed. Under direct visualization, a sequential examination of the wrist was performed. The radial styloid region of the wrist appeared normal. The scaphoid, scaphoid fossa, scapholunate ligament, lunate, and lunate fossa all appear normal, with no evidence of ligamentous injury or arthritis. The ulnar side of the wrist was highly inflamed, and difficult to visualize, however the TFCC appeared to be very loose.
The scope was removed, and an incision was made over the ulnar border of the extensor carpi ulnaris tendon. Tenotomy scissors were used to dissect down through the soft tissues, carefully protecting dorsal ulnar cutaneous nerve branches. An incision was made in the superficial sheath of the extensor carpi ulnaris tendon. The tendon was retracted radially, and an incision was made in the floor of the extensor carpi ulnaris tendon sheath. Upon entry into the joint, the ulnar styloid fragments were visible. The TFCC was directly attached to these fragments. Because of the chronic nature of the injury, it was quite clear that an attempt to repair the ulnar styloid would be useless. The bone fragments were then removed under direct visualization. Fluoroscopy was used to confirm removal of all ulnar styloid fragments. The peripheral aspect of the TFCC was then identified and gently mobilized. It was secured to the remaining ulnar styloid periosteal and extensor carpi ulnaris sub-sheath using
Just wanted someones opinion.
I get 29840 59--seperate procedure( patient was pushing coffee table this summer and heard a pop) 842.00
25107---(patient also had an old wrist fracture untreated 30 years ago..719.43)
The scope was removed, and an incision was made over the ulnar border of the extensor carpi ulnaris tendon. Tenotomy scissors were used to dissect down through the soft tissues, carefully protecting dorsal ulnar cutaneous nerve branches. An incision was made in the superficial sheath of the extensor carpi ulnaris tendon. The tendon was retracted radially, and an incision was made in the floor of the extensor carpi ulnaris tendon sheath. Upon entry into the joint, the ulnar styloid fragments were visible. The TFCC was directly attached to these fragments. Because of the chronic nature of the injury, it was quite clear that an attempt to repair the ulnar styloid would be useless. The bone fragments were then removed under direct visualization. Fluoroscopy was used to confirm removal of all ulnar styloid fragments. The peripheral aspect of the TFCC was then identified and gently mobilized. It was secured to the remaining ulnar styloid periosteal and extensor carpi ulnaris sub-sheath using
Just wanted someones opinion.
I get 29840 59--seperate procedure( patient was pushing coffee table this summer and heard a pop) 842.00
25107---(patient also had an old wrist fracture untreated 30 years ago..719.43)