My doctor originally scheduled a surgery that was supposed to be left biceps tendon repair 24342. Once she went in she didn't do this. I've entered in the procedure information, can someone please help determine what CPT's think should use.
Diagnosis: Left distal biceps tendon synovitis and partial tear
Operation: Exploration of left biceps tendon with synovectomy
Procedure:
After Esmarch exsanguination, tourniquet applied to the left arm was inflated to 175 torr. A longitudinal incision was made from the distal arm traversing the elbow crease at 90° and continuing distally into the forearm on the volar surface. This was carried bluntly through subcutaneous tissue to identify the biceps tendon. The biceps tendon was encased in scar tissue which was meticulously dissected. Hemostasis was performed with bipolar cautery. There were numerous synovial cysts along with course of the distal biceps and thickened synovial sheath. These were resected and the tendon dissected to the radial insertion. While there was partial tearing of the distal biceps tendon, there was substantial healthy tendon inserting onto the bone, and a decision was made not to take down the remaining tendon in this patient. The wound was irrigated with normal saline and then with Marcaine 0.5% with epinephrine. It was closed subcutaneously with 2-0 Vircyl suture and at the skin with subcutaneous 3-0 Monocryl.
Diagnosis: Left distal biceps tendon synovitis and partial tear
Operation: Exploration of left biceps tendon with synovectomy
Procedure:
After Esmarch exsanguination, tourniquet applied to the left arm was inflated to 175 torr. A longitudinal incision was made from the distal arm traversing the elbow crease at 90° and continuing distally into the forearm on the volar surface. This was carried bluntly through subcutaneous tissue to identify the biceps tendon. The biceps tendon was encased in scar tissue which was meticulously dissected. Hemostasis was performed with bipolar cautery. There were numerous synovial cysts along with course of the distal biceps and thickened synovial sheath. These were resected and the tendon dissected to the radial insertion. While there was partial tearing of the distal biceps tendon, there was substantial healthy tendon inserting onto the bone, and a decision was made not to take down the remaining tendon in this patient. The wound was irrigated with normal saline and then with Marcaine 0.5% with epinephrine. It was closed subcutaneously with 2-0 Vircyl suture and at the skin with subcutaneous 3-0 Monocryl.