wmcodylee
Networker
I am having a hard time with this procedure. My doc has asked that I find new ways to code and this procedure is one he would like coded differently.
Diagnosis:
1. Internal derangement, right wrist.
Procedure:
1. Arthroscopy radiocarpal/midcarpal joint.
2. Laser ligamentoplasty of scapholunate
3. Laser ligamentoplasty of lunotriquetrum
4. Laser ligamentoplasty of triangular fibrocartilage complex (TFCC)
5. Debridement and synovectomy of the radialcarpal and midcarpal joint.
6. Repair of scapholunate partial thermal shrinkage
6. Repair of lunotriquetrum partial thermal shrinkage
6. Repair of triangular fibrocartilage complex partial thermal shrinkage
The index and long fingers were placed in finger trap traction. Distraction was carried across the level of the radiocarpal joint. One radial portal was established for outflow, a 3-4 was established as a working port, and a 4-5 was established as a laser port. The camera was inserted into the radiocarpal joint. the radio carpal joint was inspected and the scapholunate and lunotriquetral spaces ere identified. A moderate around of synovitis was encountered along the margin of the radio carpal joint.
The laser was introduced through the 4-5 portal and a synovectomy was performed of the radiocarpal joint. The laser was the brought to the level of the triangular fibrocartilage complex where a partial tear of the TFCC was encountered.
At the level of the pre-styloid recess, a laser ligamentoplasty was performed of the triangular fibrocartilage complex. The laser was brought to the scapholunate space and ligamentoplasty was and capsulodesis was performed, tightening the scapholunate space. The TFCC was approached and a marked amount of synovitis was noted. A synovectomy was performed at the TFCC. Laser ligamentoplasty and debridement was then performed of the TFCC. With the holmium laser in a portal site, the scapholunate was repaired vial thermal shrinkage, the partial tear of the lunotriquetral was repaired via thermal shrinkage, and the TFCC was repaired via thermal shrinkage.
I use 29846 to cover the Arthroscopy, debridement, and synovectomy.
I also use 25320 for ligament repair via thermal shrinkage. 25320 MUE is only 1.
Are there any other codes I should be using to code this procedure?
Diagnosis:
1. Internal derangement, right wrist.
Procedure:
1. Arthroscopy radiocarpal/midcarpal joint.
2. Laser ligamentoplasty of scapholunate
3. Laser ligamentoplasty of lunotriquetrum
4. Laser ligamentoplasty of triangular fibrocartilage complex (TFCC)
5. Debridement and synovectomy of the radialcarpal and midcarpal joint.
6. Repair of scapholunate partial thermal shrinkage
6. Repair of lunotriquetrum partial thermal shrinkage
6. Repair of triangular fibrocartilage complex partial thermal shrinkage
The index and long fingers were placed in finger trap traction. Distraction was carried across the level of the radiocarpal joint. One radial portal was established for outflow, a 3-4 was established as a working port, and a 4-5 was established as a laser port. The camera was inserted into the radiocarpal joint. the radio carpal joint was inspected and the scapholunate and lunotriquetral spaces ere identified. A moderate around of synovitis was encountered along the margin of the radio carpal joint.
The laser was introduced through the 4-5 portal and a synovectomy was performed of the radiocarpal joint. The laser was the brought to the level of the triangular fibrocartilage complex where a partial tear of the TFCC was encountered.
At the level of the pre-styloid recess, a laser ligamentoplasty was performed of the triangular fibrocartilage complex. The laser was brought to the scapholunate space and ligamentoplasty was and capsulodesis was performed, tightening the scapholunate space. The TFCC was approached and a marked amount of synovitis was noted. A synovectomy was performed at the TFCC. Laser ligamentoplasty and debridement was then performed of the TFCC. With the holmium laser in a portal site, the scapholunate was repaired vial thermal shrinkage, the partial tear of the lunotriquetral was repaired via thermal shrinkage, and the TFCC was repaired via thermal shrinkage.
I use 29846 to cover the Arthroscopy, debridement, and synovectomy.
I also use 25320 for ligament repair via thermal shrinkage. 25320 MUE is only 1.
Are there any other codes I should be using to code this procedure?