Wiki Podiatry Coding

[tdesher]

I am trying to find a CPT code for the following dx. I have included the description as well. I work for an ASC and cannot find a straight code for this

POSTOPERATIVE DIAGNOSIS: Osteomyelitis left hallux
PROCEDURE: Resection of infected bone left hallux distal phalanx

Attention was directed to the distal aspect of the toe where an approximately 3 cm semi-elliptical incision was made. This incision was undermined both dorsally and plantarly providing access to the distal phalanx. Utilizing the rongeur, the distal one-half of the phalanx was resected removing all soft and parotic bone. The wound was then copiously irrigated and the remaining bone was rasped smooth. Specimen was sent to Pathology to rule out osteomyelitis and the wound was then reapproximated with 3-0 nylon. The wound was then dressed

 

[Gator]

The physician performs a partial excision of bone, also referred to as craterization, saucerization, sequestrectomy, or diaphysectomy for osteomyelitis or bossing of the talus or calcaneus (28120) other tarsal bone (28122), or phalanx of the toe (28124). Osteomyelitis is a pyogenic or pus producing infection of the bone. A boss or bossing is a boney protruberance. Craterization and saucerization of bone involves removing infected and necrotic bone to form a shallow depression in the bone surface that will allow drainage from the infected area. Sequestrectomy is the excision of a piece of necrotic bone that has become separated from healthy surrounding bone. Diaphysectomy involves removal of the infected portion of the shaft of a long bone. If the procedure is performed for osteomyelitis, an incision is made in the skin and carried down through the soft tissue overlying the site of the osteomyelitis. Any soft tissue sinus tracts and devitalized soft tissue are resected. The area of necrotic and infected bone is exposed. A series of drill holes are made in the necrotic and infected bone and the bone between the drill holes is excavated to create an oval window using an osteotome. Any sequestra are excised. The amount of bone removed is dependent on the location of sequestra and the extent of the infection. A curette may be used to remove devitalized tissue from the medullary canal. Debridement continues until punctate bleeding is identified in the exposed bony surface. When all devitalized and infected tissue has been removed, the wound is copiously irrigated with sterile saline or antibiotic solution. The surgical wound is loosely closed and a drain placed. If a boss is removed, the boney protuberance is exposed and excised using an osteotome to chip away the boney overgrowth.