scooter1
Expert
I have a provider who is going to do a manipulation of the hand w/ a bier block. It is workers compensation so we are trying to get authorization.
Would you use 26340 ? I don't do much hand coding, please help.
months from his right long finger traumatic amputation, index finger FDS, FDP repairs, and two ulnar digital nerve repair, right ring finger repair, and distal laceration nail bed. He still has swelling that develops in the index finger that prohibits motion. He has no good active ranging of the index finger. We have considered flexor tenolysis, but we need the joints to be more mobile before we can consider this.
PHYSICAL EXAMINATION: Examination of the patient's right hand today does show persistent swelling of the index finger, especially the PIP joint. Passively, we are able to stretch out the digit to some degree, but it does have a general stiffness. He shows some swelling to the hand right side compared to the left. Still some decreased mobility of the ring and small fingers of the right hand due to the limitations of hand use. He has decreased hypersensitivity. He has good sensation in the radial digit of the index finger and poor sensation on the ulnar digit distally of the index finger where previous nerve was repaired
We also recommend that he consider a right upper extremity steroid Bier block with manipulation of the hand. We hope that this could advance his overall mobility of the hand over time.
Would you use 26340 ? I don't do much hand coding, please help.
months from his right long finger traumatic amputation, index finger FDS, FDP repairs, and two ulnar digital nerve repair, right ring finger repair, and distal laceration nail bed. He still has swelling that develops in the index finger that prohibits motion. He has no good active ranging of the index finger. We have considered flexor tenolysis, but we need the joints to be more mobile before we can consider this.
PHYSICAL EXAMINATION: Examination of the patient's right hand today does show persistent swelling of the index finger, especially the PIP joint. Passively, we are able to stretch out the digit to some degree, but it does have a general stiffness. He shows some swelling to the hand right side compared to the left. Still some decreased mobility of the ring and small fingers of the right hand due to the limitations of hand use. He has decreased hypersensitivity. He has good sensation in the radial digit of the index finger and poor sensation on the ulnar digit distally of the index finger where previous nerve was repaired
We also recommend that he consider a right upper extremity steroid Bier block with manipulation of the hand. We hope that this could advance his overall mobility of the hand over time.
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