Would CPT 26121 be appropriate for the following case?
I chose CPT 26121 over 26123 because I do not see any mention of contractures being released at the level of the interphalangeal joint, only the trigger finger release, and the pathology states palmer fibromatosis. CPT 26055 is included in 26121.
POSTOPERATIVE DIAGNOSES: 1. Right ring finger trigger digit. 2. Right ring finger Dupuytren nodule.
OPERATIONS PERFORMED: 1. Right ring finger A1 pulley release. 2. Right ring finger Dupuytren nodule excision
Pathology report states: Fascia, right hand, excision: Compatible with palmar fibromatosis. No malignancy identified.
The forearm tourniquet was applied, and the hand table was attached to the operative side of the gurney. The patient then underwent infiltration of local anesthetic into the soft tissues overlying the nodule just distal to the distal palmar crease in line with the right ring finger tendon sheath. After injecting 10 mL of local anesthetic, the patient underwent prep and drape. After prep and drape, a timeout was performed. After a routine timeout, I proceeded with the procedure. I made a chevron-shaped incision overlying the nodule and the tendon sheath of the right ring finger centered at the distal palmar crease. Sharp dissection through the skin was followed by elevation of full-thickness skin flaps off the nodule and early cord that had formed proximal to the nodule. After exposing the cord and nodule, I transected it proximally and then elevated the cord and nodule, excising the cord and nodule in its entirety. I exposed the tendon sheath and visualized the tendon sheath and opened the A1 pulley sharply with a #15 blade. I completed my release distally releasing a portion of the A2 pulley but leaving the majority of the A2 pulley intact. The tourniquet was deflated. I passed off the nodule as specimen. I irrigated the wound fully with sterile normal saline.
I chose CPT 26121 over 26123 because I do not see any mention of contractures being released at the level of the interphalangeal joint, only the trigger finger release, and the pathology states palmer fibromatosis. CPT 26055 is included in 26121.
POSTOPERATIVE DIAGNOSES: 1. Right ring finger trigger digit. 2. Right ring finger Dupuytren nodule.
OPERATIONS PERFORMED: 1. Right ring finger A1 pulley release. 2. Right ring finger Dupuytren nodule excision
Pathology report states: Fascia, right hand, excision: Compatible with palmar fibromatosis. No malignancy identified.
The forearm tourniquet was applied, and the hand table was attached to the operative side of the gurney. The patient then underwent infiltration of local anesthetic into the soft tissues overlying the nodule just distal to the distal palmar crease in line with the right ring finger tendon sheath. After injecting 10 mL of local anesthetic, the patient underwent prep and drape. After prep and drape, a timeout was performed. After a routine timeout, I proceeded with the procedure. I made a chevron-shaped incision overlying the nodule and the tendon sheath of the right ring finger centered at the distal palmar crease. Sharp dissection through the skin was followed by elevation of full-thickness skin flaps off the nodule and early cord that had formed proximal to the nodule. After exposing the cord and nodule, I transected it proximally and then elevated the cord and nodule, excising the cord and nodule in its entirety. I exposed the tendon sheath and visualized the tendon sheath and opened the A1 pulley sharply with a #15 blade. I completed my release distally releasing a portion of the A2 pulley but leaving the majority of the A2 pulley intact. The tourniquet was deflated. I passed off the nodule as specimen. I irrigated the wound fully with sterile normal saline.