Any opinions would GREATLY be appreciated. I've read this note so many times and can not come up with anything....
This is a 7 yo patient who got their foot stuck in an ATV
"The toes were irrigated with 2 L of normal saline. The 2nd toe, the distal phalanx was gone. The middle phalanx bone was protruding. It was rongeured back only a millimeter or 2. I curetted out the inside of the bone as there was some minor debirs in it. There was inferior skin remaining. I closed this secondarily using 4-0 chromic catgut. With regard to the 3rd toe, there was a portion of the nail bed, still intact. A very small medial portion of the nail remained. I trimmed the nail back. I irrigated the wound. I performed minimal sharp debridement with a kinfe to freshen the edges. I then closed it with 4-0 chromic catgut..."
At 1st I was looking at amputation codes. But the distal portion of the phalanx was already gone. I was thinking of using 28124 or possible just using the debridement codes, 11044.
Please help!!
This is a 7 yo patient who got their foot stuck in an ATV
"The toes were irrigated with 2 L of normal saline. The 2nd toe, the distal phalanx was gone. The middle phalanx bone was protruding. It was rongeured back only a millimeter or 2. I curetted out the inside of the bone as there was some minor debirs in it. There was inferior skin remaining. I closed this secondarily using 4-0 chromic catgut. With regard to the 3rd toe, there was a portion of the nail bed, still intact. A very small medial portion of the nail remained. I trimmed the nail back. I irrigated the wound. I performed minimal sharp debridement with a kinfe to freshen the edges. I then closed it with 4-0 chromic catgut..."
At 1st I was looking at amputation codes. But the distal portion of the phalanx was already gone. I was thinking of using 28124 or possible just using the debridement codes, 11044.
Please help!!
