such78
Expert
DX: Sagittal band injury with contracture of the right 4th metacarpophalangeal joint
Procedure performed: extensor tendon tenolysis and also sagittal band of the extensor tendon tenolysis and release of the contracture of the MCP joint of the right 4th finger
Transverse incision over the MCP join was carried out. After incision the skin, the extensor tendon was found to be intact; however, there was tremendous amount of scarring. By hx, patient had struck his hand against fall approximately 6 months ago and that preoperatively patient was unable to flex the finger at all from the neutral position. Upon palpation of the MCP joint, there was no palpable central extensor tendon. The preop diagnosis was that the sagittal band was the injury and perhaps there was a subluxation of the extensor tendon. So, proposed extensor tendon reconstruction was the preoperative procedure of choice. Upon opening the wound, we see there was a tremendous amount of scarring and that the extensor tendon had adhesed down. This was then tenolysed. The sagittal band appeared to be intact; but because of prolonged contracture, the MCP joint ligament of the radial side proximally was then taken down by using 64 blade by using sliding out technique. Upon completion of this, the the MCP joint now can be passively flexed to approximately 90 degreed without any problems.
Am I correct to assign 26347 - F8 for tenolysis extensor tendon and 26437 - RT for realignment extensor tendon?
Thanks for advice
Procedure performed: extensor tendon tenolysis and also sagittal band of the extensor tendon tenolysis and release of the contracture of the MCP joint of the right 4th finger
Transverse incision over the MCP join was carried out. After incision the skin, the extensor tendon was found to be intact; however, there was tremendous amount of scarring. By hx, patient had struck his hand against fall approximately 6 months ago and that preoperatively patient was unable to flex the finger at all from the neutral position. Upon palpation of the MCP joint, there was no palpable central extensor tendon. The preop diagnosis was that the sagittal band was the injury and perhaps there was a subluxation of the extensor tendon. So, proposed extensor tendon reconstruction was the preoperative procedure of choice. Upon opening the wound, we see there was a tremendous amount of scarring and that the extensor tendon had adhesed down. This was then tenolysed. The sagittal band appeared to be intact; but because of prolonged contracture, the MCP joint ligament of the radial side proximally was then taken down by using 64 blade by using sliding out technique. Upon completion of this, the the MCP joint now can be passively flexed to approximately 90 degreed without any problems.
Am I correct to assign 26347 - F8 for tenolysis extensor tendon and 26437 - RT for realignment extensor tendon?
Thanks for advice