Wiki Ossicle Excision Hand/Wrist

Meljmichon

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I am trying to code an Ossicle Excision for the Hand/Wrist and i cannot find a code that comes near it.
Here is the Op note:

POSTOPERATIVE DIAGNOSIS:
1. Right dorsal hand mass.
2. Index metacarpal base ossicle.

PROCEDURE: Right hand excision metacarpal nonunion ossicle.

INTRAOPERATIVE FINDINGS: A large dorsal index metacarpal base ossicle nonunion.

OPERATION: After signing proper consent form, the arm was marked in preoperative hold. The
patient was taken to the operating room, given IV antibiotics and local anesthetic infiltrated in surgical
site. Proximal arm tourniquet placed. The hand was prepped and draped in the usual sterile fashion with
Betadine solution. Esmarch exsanguinations and elevation of tourniquet to 250 mmHg. After checking
proper consent form and timeout a longitudinal incision was made over the bump down to subcutaneous
tissue protecting the neurovascular structures. The extensor tendon was then opened. The ossicle was
then subperiosteally dissected. Nonunion ossicle was then removed without difficulty. Wound was
thoroughly irrigated. Skin closed using a 4-0 nylon and well-padded Coban dressing was applied. The
patient tolerated the procedure well and was taken to the recovery room in stable condition.
The patient was fitted with and instructed on the use of a durable medical good at the completion of the
procedure. This aid was given to help facilitate patient recovery, decrease pain, and increase function
post operatively.


Can anyone help? I am having no luck.
 
Maybe this will help

Hey

Try looking at
CPT 25075 3.96 RVU
or 25120 6.27 RVU
25130 5.43 RVU
25151 7.68 RVU

Your Op report is very vague from the DR so when I read it. It appears the ossicle(bone) was removed from the wrist area(subcutaneous) which could be any of these codes but the higher the RVU the more money for the procedure so look at these and decide which would be the best CPT code. If I was coding this I would use CPT 25151 because the DR removed bone which CPT code 25151 is partial excison (craterization= process of removing a mass or diaphysectomy= complete removal of bone) radius..So hope this helps..Notes appear to cover these codes but coding is very bias so choose confidently. Have a Great Day
 
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