rlaughlin42
Contributor
24575 was billed along with 24000 (Arthrotomy, elbow, including exploration, drainage, or removal of foreign body). I am questioning the billing of 24000. I am thinking it should have been 23930 for the removal and irrigation of the deep hematoma. Any input would be greatly appreciated!
The medial incision was marked. Approximately 3 cm medial incision was made. We dissected through
the skin and subcutaneous tissue. Gentle dissection was performed through the subcutaneous
tissue to protect all traversing sensory nerves. The fracture was identified. Deep fracture
hematoma was irrigated and removed from the wound. Gentle release of the ulnar nerve
adjacent to the fracture site was performed. The fracture was reduced and held with a single K
wire. Fluoroscopic images were obtained to ensure appropriate placement of the K wire and
fracture reduction. The appropriate depth was measured. The near cortex was drilled and a
3.5 mm cannulated screw from Zimmer was then placed across the fracture site obtaining
excellent compression at the fracture site. The elbow was taken through range of motion and
there was no instability of the fracture fixation. The wound was copiously irrigated and the
tourniquet was released. Hemostasis was obtained using electrocautery. The skin and
subcutaneous tissue was infiltrated with 0.25% Marcaine with epinephrine. The incision was
closed using Monocryl suture and Dermabond. Sterile dressings were applied. The patient
was placed in a splint at 90 degrees of flexion and neutral forearm rotation. She was extubated
and transferred to the hospital bed in stable condition. Needle, instrument, and sponge counts
were correct x2 at the end of the procedure. She was discharged home after meeting same
day surgery criteria
The medial incision was marked. Approximately 3 cm medial incision was made. We dissected through
the skin and subcutaneous tissue. Gentle dissection was performed through the subcutaneous
tissue to protect all traversing sensory nerves. The fracture was identified. Deep fracture
hematoma was irrigated and removed from the wound. Gentle release of the ulnar nerve
adjacent to the fracture site was performed. The fracture was reduced and held with a single K
wire. Fluoroscopic images were obtained to ensure appropriate placement of the K wire and
fracture reduction. The appropriate depth was measured. The near cortex was drilled and a
3.5 mm cannulated screw from Zimmer was then placed across the fracture site obtaining
excellent compression at the fracture site. The elbow was taken through range of motion and
there was no instability of the fracture fixation. The wound was copiously irrigated and the
tourniquet was released. Hemostasis was obtained using electrocautery. The skin and
subcutaneous tissue was infiltrated with 0.25% Marcaine with epinephrine. The incision was
closed using Monocryl suture and Dermabond. Sterile dressings were applied. The patient
was placed in a splint at 90 degrees of flexion and neutral forearm rotation. She was extubated
and transferred to the hospital bed in stable condition. Needle, instrument, and sponge counts
were correct x2 at the end of the procedure. She was discharged home after meeting same
day surgery criteria