01871073
New
I coded this as 29846 and 29999 compared to 25240. Medicare part B has denied 29999 stating service is not supported within notes. Any insight on this would be great.
upper arm was placed in an arm holder and traction was then placed across her fingers using finger traps attached to middle and ring fingers. Ten pounds of traction was used. Four arthroscopy portals were made in the dorsum of right wrist for the 3-4 portal, 4-5 portal, RMC portal, and UMC portal. Through the 3-4 portal arthroscope was introduced using blunt dissection. The radiocarpal joint appeared normal. The lunate showed grade II-III chondromalacia dorsally and there was a central TFCC noted. The TFCC tear was debrided using a basket forceps and shaver. Because of her ulnar positive wrist variance, 2 mm of distal ulna was resected using a high-speed burr.
Attention was then turned to the mid carpal joint. The arthroscope was inserted into the RMC portal and a complete tear of the scapholunate ligament as well as the lunotriquetral ligament was noted. The shaver was placed into the UMC portal and a synovectomy was performed in the mid carpal joint. The minimal chondromalacia noted on the proximal capitate. All instruments were removed. The portals were closed with Steri-Strips and 5-0 nylon sutures. A dry, sterile dressing was applied with a volar splint. She was discharged to the recovery room in stable condition.
thank you
upper arm was placed in an arm holder and traction was then placed across her fingers using finger traps attached to middle and ring fingers. Ten pounds of traction was used. Four arthroscopy portals were made in the dorsum of right wrist for the 3-4 portal, 4-5 portal, RMC portal, and UMC portal. Through the 3-4 portal arthroscope was introduced using blunt dissection. The radiocarpal joint appeared normal. The lunate showed grade II-III chondromalacia dorsally and there was a central TFCC noted. The TFCC tear was debrided using a basket forceps and shaver. Because of her ulnar positive wrist variance, 2 mm of distal ulna was resected using a high-speed burr.
Attention was then turned to the mid carpal joint. The arthroscope was inserted into the RMC portal and a complete tear of the scapholunate ligament as well as the lunotriquetral ligament was noted. The shaver was placed into the UMC portal and a synovectomy was performed in the mid carpal joint. The minimal chondromalacia noted on the proximal capitate. All instruments were removed. The portals were closed with Steri-Strips and 5-0 nylon sutures. A dry, sterile dressing was applied with a volar splint. She was discharged to the recovery room in stable condition.
thank you