solocoder
Expert
Can someone tell me if I can code 14040 in addition to the amputation here?
AMPUTATION OF THE LEFT 3RD PROXIMAL INTERPHALANGEAL JOINT
Attention was directed to the dorsal aspect of his left third digit, where a transverse incision was performed extending from the medial aspect the proximal interphalangeal joint extending laterally. The primary incision was then extended distally into the medial and lateral aspects of the digit. The two incisions were connected on the plantar aspect of his third digit using a sharp dissection. The incisions were deepened in the same plane paying careful attention to preserve all the vessels and nerves which were retracted and cauterized as necessary.
By using sharp dissection, transverse capsulotomy was performed through the dorsal aspect of the third proximal interphalangeal joint, and the medial and lateral collateral ligaments were identified and transected. The distal tip of the digit was amputated in toto from the area. The removed digit was sent to microbiology for culture and sensitivity. The area was fully flushed with sterile saline solution.
The plantar skin flap was then advanced dorsally, and it was trimmed to fit. Tourniquet was then released with a total tourniquet time of 8 minutes. A warm and pink state was noted to return to the patient's digits at this time. All the bleeders were ligated. The deep closure was done with #4-0 Vicryl in a horizontal mattress fashion and the skin edges were reapproximated in simple interrupted fashion using #4-0 nylon.
AMPUTATION OF THE LEFT 3RD PROXIMAL INTERPHALANGEAL JOINT
Attention was directed to the dorsal aspect of his left third digit, where a transverse incision was performed extending from the medial aspect the proximal interphalangeal joint extending laterally. The primary incision was then extended distally into the medial and lateral aspects of the digit. The two incisions were connected on the plantar aspect of his third digit using a sharp dissection. The incisions were deepened in the same plane paying careful attention to preserve all the vessels and nerves which were retracted and cauterized as necessary.
By using sharp dissection, transverse capsulotomy was performed through the dorsal aspect of the third proximal interphalangeal joint, and the medial and lateral collateral ligaments were identified and transected. The distal tip of the digit was amputated in toto from the area. The removed digit was sent to microbiology for culture and sensitivity. The area was fully flushed with sterile saline solution.
The plantar skin flap was then advanced dorsally, and it was trimmed to fit. Tourniquet was then released with a total tourniquet time of 8 minutes. A warm and pink state was noted to return to the patient's digits at this time. All the bleeders were ligated. The deep closure was done with #4-0 Vicryl in a horizontal mattress fashion and the skin edges were reapproximated in simple interrupted fashion using #4-0 nylon.