kkidd91
Contributor
I am thinking I may be missing details to help chose the correct CPT code. The physicians office authorized CPT 15620, however I do not see where a flap was previously created, and I am thinking CPT 15574 may be more appropriate. Can CPT 15620 be used since the surgery was delayed days after the amputation occurred?
Any advice or thoughts are greatly appreciated. Thank you in advance.
The office note states "Patient presents to my clinic on 07/22/2024 for evaluation of right thumb injury suffered when her dog bit her on 07/18/2024. She was seen at ER and placed into a clean dressing told Plan is to proceed with I & D and Moberg flap to close her right thumb. DOS 07/23/24.
POSTOPERATIVE DIAGNOSIS: Partial tip amputation, right thumb.
OPERATION PERFORMED: Moberg flap, right thumb
DESCRIPTION OF PROCEDURE: The patient was met in the holding area. The surgical site was marked and confirmed. Questions were answered. The patient then underwent transport to the OR. The bed was rotated to allow better access to the right upper extremity. The patient had previously undergone regional block. She was prepped and draped with Betadine after application of a forearm tourniquet. After prep and drape, timeout was performed. After routine timeout, I proceeded with the procedure. I exsanguinated the extremity with an Esmarch bandage and inflated the tourniquet to 250 mmHg. I made the incisions on the mid lateral line on both the radial and ulnar aspects of the thumb and performed careful blunt dissection. I elevated full-thickness flaps off the tendon sheath and mobilized the soft tissue on the volar aspect of the thumb down to the MCP flexion crease. I was then able to flex the thumb IP joint to cover the tip of the digit. I secured the Moberg flap using chromic sutures through the digit as well as along the sides of the digit using a nylon suture. After securing the Moberg flap to cover the tip of the phalanx, I washed and dried the extremity and applied dressings of Xeroform, sterile gauze, sterile Webril, and a thumb spica splint overwrapped with an Ace bandage. All digits were pink and viable at the conclusion. The patient was awakened and taken to the recovery room. She arrived in the recovery room in stable condition still under the influence of IV sedation. All counts correct x2
Any advice or thoughts are greatly appreciated. Thank you in advance.
The office note states "Patient presents to my clinic on 07/22/2024 for evaluation of right thumb injury suffered when her dog bit her on 07/18/2024. She was seen at ER and placed into a clean dressing told Plan is to proceed with I & D and Moberg flap to close her right thumb. DOS 07/23/24.
POSTOPERATIVE DIAGNOSIS: Partial tip amputation, right thumb.
OPERATION PERFORMED: Moberg flap, right thumb
DESCRIPTION OF PROCEDURE: The patient was met in the holding area. The surgical site was marked and confirmed. Questions were answered. The patient then underwent transport to the OR. The bed was rotated to allow better access to the right upper extremity. The patient had previously undergone regional block. She was prepped and draped with Betadine after application of a forearm tourniquet. After prep and drape, timeout was performed. After routine timeout, I proceeded with the procedure. I exsanguinated the extremity with an Esmarch bandage and inflated the tourniquet to 250 mmHg. I made the incisions on the mid lateral line on both the radial and ulnar aspects of the thumb and performed careful blunt dissection. I elevated full-thickness flaps off the tendon sheath and mobilized the soft tissue on the volar aspect of the thumb down to the MCP flexion crease. I was then able to flex the thumb IP joint to cover the tip of the digit. I secured the Moberg flap using chromic sutures through the digit as well as along the sides of the digit using a nylon suture. After securing the Moberg flap to cover the tip of the phalanx, I washed and dried the extremity and applied dressings of Xeroform, sterile gauze, sterile Webril, and a thumb spica splint overwrapped with an Ace bandage. All digits were pink and viable at the conclusion. The patient was awakened and taken to the recovery room. She arrived in the recovery room in stable condition still under the influence of IV sedation. All counts correct x2