This was billed out as a 29999 initially, now they was a corrected claim done using 29999, 29891, and 29898. I need help because I don't see any of these charges before they are billed because a certified coder doesn't go over the charges before they are billed. I am a certified coder but I work in the Billing department and post payments after things are processed.
Please help don't know what to do????
PREOPERATIVE DIAGNOSIS: Right talus osteochondral lesion and ankle impingement
POSTOPERATIVE DIAGNOSIS: Right talus osteochondral lesion and ankle impingement
PROCEDURES PERFORMED: Right ankle arthroscopy with talus osteochondral defect microfracture and Biocartilage transfer and anterior and lateral soft tissue impingement debridgement
ANESTHESIA: Regional block plus general
INDICATIONS: See H&P
SURGICAL DETAIL: After informed consent and documentation of proper site and placement of regional block by anesthesia, the patient was taken to the operating room and placed in a supine position on the operating room table were IV anitbiotics were administered and general anesthesia was commenced. A tourniquet was place around the upper aspect of the right lower extremity and the right lower extremity thigh was placed on a thigh holder and the right lower extremity was prepped and draped in the normal sterile fashion. A final timeout was done to ensure proper patient, site, and procedure. The ankle distraction device by Arthrex was then placed in approximately ten pounds of traction across the ankle joint. At this point utilizing a medial portal first with insufflation of the ankle joint with sterile saline first a nick and spread method was used to insert the camera portal and then a medial portal and then under direct visualization a lateral portal was made with the nick and spread method as well. Diagnostic arthroscopy of the ankle was performed showing the central lateral osteochondral defect of the talus measuring 10x10mms. A ring curette was utilized at this point to clear the area of the osteochondral defect to stable rims. An arthroscopic shaver was then used to debride the anterior and lateral gutters of impingement and then also to debride the intra-articular space of denuded cartilage. Microfracture awls were then utilized to perform microfracture of the 10x10mm defect. The ankle was then drained of all intra-articular fluid and the Arthrex BioCartilage inserter was used to fill the defect with Biocartilage. After this was completed and fiber glue was placed over top of the Biocartilage and allowed to dry for 10 minutes, all instrumentation was taken from the ankle. The ankle incisions were closed with simple sutures and a soft tissue dressing was placed. A L & U splint was placed, tourniquet was let down, and the patient was awoken from anesthesia and transferred to the postanesthesia care unit in good condition.
Please help don't know what to do????
PREOPERATIVE DIAGNOSIS: Right talus osteochondral lesion and ankle impingement
POSTOPERATIVE DIAGNOSIS: Right talus osteochondral lesion and ankle impingement
PROCEDURES PERFORMED: Right ankle arthroscopy with talus osteochondral defect microfracture and Biocartilage transfer and anterior and lateral soft tissue impingement debridgement
ANESTHESIA: Regional block plus general
INDICATIONS: See H&P
SURGICAL DETAIL: After informed consent and documentation of proper site and placement of regional block by anesthesia, the patient was taken to the operating room and placed in a supine position on the operating room table were IV anitbiotics were administered and general anesthesia was commenced. A tourniquet was place around the upper aspect of the right lower extremity and the right lower extremity thigh was placed on a thigh holder and the right lower extremity was prepped and draped in the normal sterile fashion. A final timeout was done to ensure proper patient, site, and procedure. The ankle distraction device by Arthrex was then placed in approximately ten pounds of traction across the ankle joint. At this point utilizing a medial portal first with insufflation of the ankle joint with sterile saline first a nick and spread method was used to insert the camera portal and then a medial portal and then under direct visualization a lateral portal was made with the nick and spread method as well. Diagnostic arthroscopy of the ankle was performed showing the central lateral osteochondral defect of the talus measuring 10x10mms. A ring curette was utilized at this point to clear the area of the osteochondral defect to stable rims. An arthroscopic shaver was then used to debride the anterior and lateral gutters of impingement and then also to debride the intra-articular space of denuded cartilage. Microfracture awls were then utilized to perform microfracture of the 10x10mm defect. The ankle was then drained of all intra-articular fluid and the Arthrex BioCartilage inserter was used to fill the defect with Biocartilage. After this was completed and fiber glue was placed over top of the Biocartilage and allowed to dry for 10 minutes, all instrumentation was taken from the ankle. The ankle incisions were closed with simple sutures and a soft tissue dressing was placed. A L & U splint was placed, tourniquet was let down, and the patient was awoken from anesthesia and transferred to the postanesthesia care unit in good condition.