tbensonite
Guest
Greetings all! Would really appreciate some help with skin graft codes. Patient had a right middle finger mass. Our hand surgeon did this procedure and I've got little to no experience coding skin grafting procedures. Here's a snippet of the work done-
...a 2cm X 2cm rhomboid excision of the mass. I had pretty good borders and felt that I was at least 2 mm or greater away from the mass itself. It did not seem to invade into the extensor tendon. I kept the peritenon of the tendon intact. I excised and tagged the distal and long and the radial and short. I sent it off for pathology. I then performed a rhomboid flap. However, the rhomboid flap did not mobilize as much as I wanted to. Skin was pretty nonmobile at that point. I mobilized it as much as I could. A 5-0 nylon secured it. At that point, I saw a deficit of about 15mm X 30mm. I felt that I needed to go ahead and get a full-thickness skin graft...I incised the full-thickness skin graft measuring 2cm X 30mm. At that point, I then defatted the skin graft. I in-set it into the finger. I used 5-0 nylon to secure it. Prior to the in-set of it, I released the tourniquet to make sure I had controlled all the bleeders.
At that point, I then fashioned the skin graft to fit the defect which was 50mm X 30mm. ..I then placed a bolster dressing over the skin graft with cotton balls, mineral oil and Xeroform etc.
I chose 'excisional biopsy of right middle finger mass- 26111, but just not sure about the skin transfer (less than 10 cm2) and the Application of full-thickness skin graft measuring 20mm X 1.5mm X 30 mm.
Anybody who would be willing to get me in the right direction would be my hero![Eek! :eek: :eek:](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
...a 2cm X 2cm rhomboid excision of the mass. I had pretty good borders and felt that I was at least 2 mm or greater away from the mass itself. It did not seem to invade into the extensor tendon. I kept the peritenon of the tendon intact. I excised and tagged the distal and long and the radial and short. I sent it off for pathology. I then performed a rhomboid flap. However, the rhomboid flap did not mobilize as much as I wanted to. Skin was pretty nonmobile at that point. I mobilized it as much as I could. A 5-0 nylon secured it. At that point, I saw a deficit of about 15mm X 30mm. I felt that I needed to go ahead and get a full-thickness skin graft...I incised the full-thickness skin graft measuring 2cm X 30mm. At that point, I then defatted the skin graft. I in-set it into the finger. I used 5-0 nylon to secure it. Prior to the in-set of it, I released the tourniquet to make sure I had controlled all the bleeders.
At that point, I then fashioned the skin graft to fit the defect which was 50mm X 30mm. ..I then placed a bolster dressing over the skin graft with cotton balls, mineral oil and Xeroform etc.
I chose 'excisional biopsy of right middle finger mass- 26111, but just not sure about the skin transfer (less than 10 cm2) and the Application of full-thickness skin graft measuring 20mm X 1.5mm X 30 mm.
Anybody who would be willing to get me in the right direction would be my hero