Wiki fixation or hammertoe

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On the right second toe, I was able to ellipse out the granulomatous tissue and send for specimen to Pathology. We also removed the Trim-It pin, which was remaining, and likely causing this soft tissue irritation.

At this point, I was able to use a rongeur, curette, and Freer to help to débride the soft tissues in the periphery of the incision site. I was then able to débride the bone as well. I was able to use a 6-2 K-wire to go from proximal to distal down the middle phalanx and distal phalanx. I then retrograded this through the proximal phalanx, and finally up into the second metatarsal head with the foot held in neutral plantar flexion.

I really don't know what direction to go with this.

he did fixate the toe???

opinions

28285??

28666??
28043??
 
I believe it's going to depend on the diagnosis. This appears to be an open procedure so 2866 is not correct. Maybe 28675 if this was due to an IP dislocation. If the dx is hammertoe, 28285 would be correct. Yes, fixation was performed. That is what the k-wire is for. Definitely not 28043 as no tumor is mentioned. If I were going to guess, which I wouldn't in the real world, I would guess this is a hammertoe correction since the Trim-It pin has, to my knowledge, not been reccommended for any other use. You may be able to bill for the removal of the previous pin but I'm not positive of that.
 
Thank you for your imput

I spoke to the doc and the office manager and as I suspected it is 28285. I was questioning this because sometimes what a doc does is more or less and to me he was not clear as his intent. The office coder just codes what the doc says so I went with my gut and sure enough It Was a hammertoe revision.... I am not going to code for the removal as to this is included in 28285..
Thanks again:)
 
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