jerseygirl20
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DX is LEft type II distal clavicle fracture.
I am thinking this should be coded as a open claviculectomy?
OPERATIVE PROCEDURE IN DETAIL: The patient was identified and the appropriate extremity was confirmed. After adequate general anesthesia was induced, the patient was placed in the beach-chair position and the left upper extremity was prepped and draped in the usual sterile fashion. The patient was given 500 mg of vancomycin within one hour of the surgical time. A curvilinear incision was made over the distal clavicle. The skin was sharply incised and the soft tissue was sharply incised until the clavicular fracture came into view. Immediately apparent was the clavicle fracture. Fortunately, the more proximal clavicle still had the coracoclavicular ligament intact and the more proximal clavicle was stable. The distal fragment measured approximately 10-12 mm. It was felt that the patient would be best warranted with removal of the fragment. This would function like an oversized Mumford procedure since the coracoclavicular ligament complex was intact. We painstakingly and meticulously dissected out the fragment from the AC joint. The wound was then copiously irrigated and all loose debris was removed. The deltotrapezial fascia was then reapproximated with interrupted 0 Vicryl suture, the subcutaneous soft tissue was reapproximated with 2-0 Vicryl and the skin was closed with 4-0 Monocryl. A sterile dressing followed. The patient tolerated the procedure well and was returned to the Recovery Room in satisfactory condition.
I am thinking this should be coded as a open claviculectomy?
OPERATIVE PROCEDURE IN DETAIL: The patient was identified and the appropriate extremity was confirmed. After adequate general anesthesia was induced, the patient was placed in the beach-chair position and the left upper extremity was prepped and draped in the usual sterile fashion. The patient was given 500 mg of vancomycin within one hour of the surgical time. A curvilinear incision was made over the distal clavicle. The skin was sharply incised and the soft tissue was sharply incised until the clavicular fracture came into view. Immediately apparent was the clavicle fracture. Fortunately, the more proximal clavicle still had the coracoclavicular ligament intact and the more proximal clavicle was stable. The distal fragment measured approximately 10-12 mm. It was felt that the patient would be best warranted with removal of the fragment. This would function like an oversized Mumford procedure since the coracoclavicular ligament complex was intact. We painstakingly and meticulously dissected out the fragment from the AC joint. The wound was then copiously irrigated and all loose debris was removed. The deltotrapezial fascia was then reapproximated with interrupted 0 Vicryl suture, the subcutaneous soft tissue was reapproximated with 2-0 Vicryl and the skin was closed with 4-0 Monocryl. A sterile dressing followed. The patient tolerated the procedure well and was returned to the Recovery Room in satisfactory condition.