I'm struggling with this one....Would the pinning of the IP joint be included in the repair of the extensor tendon 26418? or would I bill it separate?
Any help would be great! Thank you in advance!
Open fracture, left thumb with significant extensor tendon injury.
PROCEDURE PERFORMED WAS:
1.Irrigation and debridement down to bone.
2.Open repair of extensor tendon laceration with pinning of IP joint.
TECHNIQUE: The patient was brought to the operating room where a satisfactory level of local anesthetic was introduced in the usual fashion. He had fairly significant pulsatile bleeding, so we did put up a tourniquet and then we prepped and draped in the usual fashion. We then irrigated thoroughly and we cauterized the digital artery that was bleeding. We then explored the joint and noted that the extensor insertion on the base of the distal phalanx was intact on the far ulnar side, but it was completely absent radial to that. At this point, we elected to place a Mitek suture anchor in the area and then did a extensor tendon repair with 2-0 Ethibond. We then oversewed with further 2-0 Ethibond. We then used a 0.54 K wire to hold the IP joint reduced in extension to protect the repair. We then irrigated thoroughly and repaired the pulp wound with 4-0 nylon in an interrupted fashion.
Any help would be great! Thank you in advance!
Open fracture, left thumb with significant extensor tendon injury.
PROCEDURE PERFORMED WAS:
1.Irrigation and debridement down to bone.
2.Open repair of extensor tendon laceration with pinning of IP joint.
TECHNIQUE: The patient was brought to the operating room where a satisfactory level of local anesthetic was introduced in the usual fashion. He had fairly significant pulsatile bleeding, so we did put up a tourniquet and then we prepped and draped in the usual fashion. We then irrigated thoroughly and we cauterized the digital artery that was bleeding. We then explored the joint and noted that the extensor insertion on the base of the distal phalanx was intact on the far ulnar side, but it was completely absent radial to that. At this point, we elected to place a Mitek suture anchor in the area and then did a extensor tendon repair with 2-0 Ethibond. We then oversewed with further 2-0 Ethibond. We then used a 0.54 K wire to hold the IP joint reduced in extension to protect the repair. We then irrigated thoroughly and repaired the pulp wound with 4-0 nylon in an interrupted fashion.