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Is there a cpt code to use for interpositional placement extensor digitorum brevis muscle belly? The first procedure I have as 28116, but cant find one for interpositional placement.
I appreciate any info.
Vickie
OPERATIVE PROCEDURE #1: Calcaneonavicular coalition, right.
The patient was transported from the preoperative holding area where IV access had been established successfully without problems. Light sedation was given to the patient. He was placed on the table in the supine position. The pneumatic tourniquet was placed about the thigh level. The extremity was scrubbed, prepped, and draped in the usual sterile manner. The limb was elevated, exsanguinated, and the pneumatic tourniquet was inflated to approximately 325 mmHg.
Attention was then directed to the lateral aspect of the hindfoot where C-arm fluoroscopy confirmed orientation spatially. The calcaneonavicular coalition area had been marked on the skin layer utilizing a surgical marking pen. The incision was made obliquely overlying the navicular area. Dissection was taken down through the skin and subcutaneous tissue. All bleeders were ligated and cauterized as necessary. Dissected continued deep down to the extensor retinaculum that was incised. The extensor digitorum muscle belly was then undermined and freed from the roof of the calcaneus at the anterior tuberosity. The limb was reflected and the calcaneonavicular coalition was brought into view. An osteotome and mallet were used for resection of the calcaneonavicular coalition from the most inferior area at the anterior tuberosity of the calcaneus as well as at the most lateral aspect of the navicular. The coalition was resected successfully and rongeured. The Chopart's joint was taken through a range of motion, which was restricted preoperatively, and it was full. The area was given a final flush.
OPERATIVE PROCEDURE #2: Interpositional placement of extensor digitorum muscle belly, right foot.
The extensor digitorum muscle belly at the origin was inserted into the calcaneonavicular coalition area and sutured to the periosteum utilizing 2-0 Vicryl simple stitches.
The extensor retinaculum was then repaired utilizing 2-0 Vicryl simple stitches. The subcutaneous tissue was repaired utilizing 4-0 Vicryl subcuticular running stitches. The skin was closed utilizing 4-0 nylon horizontal mattress and simple stitches in alternating fashion. Local anesthesia consisting of 20 cc of Marcaine plain was infiltrated in an ankle ring field block. An iodine compression dressing was applied. The tourniquet was released with vascular response noted to the extremity. A short leg cast was then applied with the foot dorsiflexed in neutral at the ankle. The patient tolerated the procedure and anesthesia well. He was transferred from the operating room to the recovery room in stable condition.
I appreciate any info.
Vickie
OPERATIVE PROCEDURE #1: Calcaneonavicular coalition, right.
The patient was transported from the preoperative holding area where IV access had been established successfully without problems. Light sedation was given to the patient. He was placed on the table in the supine position. The pneumatic tourniquet was placed about the thigh level. The extremity was scrubbed, prepped, and draped in the usual sterile manner. The limb was elevated, exsanguinated, and the pneumatic tourniquet was inflated to approximately 325 mmHg.
Attention was then directed to the lateral aspect of the hindfoot where C-arm fluoroscopy confirmed orientation spatially. The calcaneonavicular coalition area had been marked on the skin layer utilizing a surgical marking pen. The incision was made obliquely overlying the navicular area. Dissection was taken down through the skin and subcutaneous tissue. All bleeders were ligated and cauterized as necessary. Dissected continued deep down to the extensor retinaculum that was incised. The extensor digitorum muscle belly was then undermined and freed from the roof of the calcaneus at the anterior tuberosity. The limb was reflected and the calcaneonavicular coalition was brought into view. An osteotome and mallet were used for resection of the calcaneonavicular coalition from the most inferior area at the anterior tuberosity of the calcaneus as well as at the most lateral aspect of the navicular. The coalition was resected successfully and rongeured. The Chopart's joint was taken through a range of motion, which was restricted preoperatively, and it was full. The area was given a final flush.
OPERATIVE PROCEDURE #2: Interpositional placement of extensor digitorum muscle belly, right foot.
The extensor digitorum muscle belly at the origin was inserted into the calcaneonavicular coalition area and sutured to the periosteum utilizing 2-0 Vicryl simple stitches.
The extensor retinaculum was then repaired utilizing 2-0 Vicryl simple stitches. The subcutaneous tissue was repaired utilizing 4-0 Vicryl subcuticular running stitches. The skin was closed utilizing 4-0 nylon horizontal mattress and simple stitches in alternating fashion. Local anesthesia consisting of 20 cc of Marcaine plain was infiltrated in an ankle ring field block. An iodine compression dressing was applied. The tourniquet was released with vascular response noted to the extremity. A short leg cast was then applied with the foot dorsiflexed in neutral at the ankle. The patient tolerated the procedure and anesthesia well. He was transferred from the operating room to the recovery room in stable condition.