I drew out an incision over the medial aspect of the Achilles. I was able to dissect down through the skin and subcutaneous tissues to preserve the paratenon, which was reflected medially and laterally. I was able to center my incision based over the Achilles exostosis, which was dissected out around the Achilles insertion site. The Achilles insertional fibers were attached to this large bone spur, which was removed. This did require debridement of the Achilles tendon, with less than 50% takedown of the tendon. I did use a BioComposite corkscrew anchor with two barb wire sutures to help to use a Krackow running locking stitch up and down the distal portion of the Achilles insertional site, with four separate locking stitches, with knots tied distally. This provided excellent fixation. I could range the foot and ankle, with no evidence of gap formation.
I was able to get a large spur that measured greater than 3 cm in size in length x 1 cm depth off of the posterior aspect of the calcaneus using osteotomes. It did require less than 50% debridement of the Achilles. I was able to close the peritenon,
Doc wants 28120 and 27650
But I just don't see that
28119 726.73 and 27650 59 with 726.71 dx
however the 27650 is more expensive. Could someone take a crack at it...I called the docs office and they are ok with what the doc wants.????
I was able to get a large spur that measured greater than 3 cm in size in length x 1 cm depth off of the posterior aspect of the calcaneus using osteotomes. It did require less than 50% debridement of the Achilles. I was able to close the peritenon,
Doc wants 28120 and 27650
But I just don't see that
28119 726.73 and 27650 59 with 726.71 dx
however the 27650 is more expensive. Could someone take a crack at it...I called the docs office and they are ok with what the doc wants.????
