• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Radical Synovectomy wrist extensor compartment

Create Wiki
J

Joyce Burchett

Guest
Messages
43
Location
Mount Auburn, IL
Best answers
0
Pt. has rheumatoid arthrosis involving the Rt wrist; marked extensor tenosynovitis secondary to rheumatoid arthritis; distal radial ulnar joint arthrosis with subluxation ulnar head; extensor tendon rupture involving the 3rd, 4th, 5th digits. Op Procedure: Radical synovectomy Rt wrist extensor compartment; Ulnar head resection; extensor tendon reconstruction digits 3,4,5. I have looked at CPT 25116, 25119, 25320, 25310,25270.

I am not sure how to code these procedures. Are there any Ortho Hand Coders that would be willing to look at this op report for coding help.
 
2nd Request--Radical Synovectomy Extensor Tendon

Op Report: Longitudinal incision made over dorsal aspect wrist. Dissection down through subc tissue. Full thickness flaps elevated off extensor mechanism. Flap of extensor mechanism taken down off of 2nd dorsal compartment & reflected all way over to 6th compartment. This allowed full exposure to extensor compartment & we did a radical synovectomy, debriding synovial tissue from each tendon. We started at the wrist extensors & proceeded to the EIP & into 4th dorsal compartment. Most of pathology was in the 4th dorsal compartment. Large amount of thick reactive synovium debrided sharply with a rongeur all the way down to carpus & we continued onto 5th dorsal compartment. Once adequate debridement we could see rupture of EDQ, EDC to 3,4, and 5. Exposed ulnar head to 5th dorsal compartment & resected with saw blade. Peristeum of ulna was used to reduce this & suture it back into the more palmar position. We then prepared for repair of 3,4 & 5. I sacrificed the EIP(extensor indicis proprius tendon distally & brought it through the the combined 3rd, 4th, & 5t:confused:h EDC using a pulvertaft weave X4. This gave excellent repair. Extensor retinaculum was reconstructed. Would this be 25119 & 25270 X3?? Please help.
 
Last edited:
2nd Request--Radical Synovectomy Extensor Tendon

Op Report: Longitudinal incision made over dorsal aspect wrist. Dissection down through subc tissue. Full thickness flaps elevated off extensor mechanism. Flap of extensor mechanism taken down off of 2nd dorsal compartment & reflected all way over to 6th compartment. This allowed full exposure to extensor compartment & we did a radical synovectomy, debriding synovial tissue from each tendon. We started at the wrist extensors & proceeded to the EIP & into 4th dorsal compartment. Most of pathology was in the 4th dorsal compartment. Large amount of thick reactive synovium debrided sharply with a rongeur all the way down to carpus & we continued onto 5th dorsal compartment. Once adequate debridement we could see rupture of EDQ, EDC to 3,4, and 5. Exposed ulnar head to 5th dorsal compartment & resected with saw blade. Periosteum of ulna was used to reduce this & suture it back into the more palmar position. We then prepared for repair of 3,4 & 5. I sacrificed the EIP(extensor indicis proprius tendon distally & brought it through the the combined 3rd, 4th, & 5th EDC using a pulvertaft weave X4. This gave excellent repair. Extensor retinaculum was reconstructed. Would this be 25119 & 25270 X3?? Please help. :confused:
 
You must log in or register to reply here.
Top