littlelora
Networker
Can someone PLEASE help me code this? I was going to use partial excision of bone, metatarsal, 28122 and partial excision of phalanx, 28124, but I don't think this really covers what he's doing. The diagnosis is rigid deformity 2nd MTP with crossover and PIP hammertoe deformity. Thank you so much!
PROCEDURE IN DETAIL:
After performing a timeout, a digital block was placed for postoperative
analgesia with quarter percent Marcaine. After this, a scalpel was used to make a longitudinal
incision after inflating a pneumatic tourniquet. The incision was dorsal over the second third
webspace. Dissection was deepened through the fat with spreading scissors. An extensor tenotomy
was performed. There was a rigid deformity of the MTP joint. After skeletonizing the distal
portion of the metatarsal, an oscillating saw was used to resect the distal portion of the second
metatarsal. Fluoroscopy was used to guide the osteotomy. I then remove the distal portion of the
metatarsal shaft and metatarsal head. After this I made a second incision transversely over the
PIP joint. I skeletonized the PIP joint and then used a rondure to resect the distal portion of
the proximal phalanx. After this was done, I lavaged both wounds and then placed a 0.062 Kirschner
pin from a proximal to distal direction out through the tip of the toe followed by retrograde
distal to proximal pinning of the metatarsal shaft. Three-view x-ray showed that the pin was
intramedullary and that the toe is well aligned.
PROCEDURE IN DETAIL:
After performing a timeout, a digital block was placed for postoperative
analgesia with quarter percent Marcaine. After this, a scalpel was used to make a longitudinal
incision after inflating a pneumatic tourniquet. The incision was dorsal over the second third
webspace. Dissection was deepened through the fat with spreading scissors. An extensor tenotomy
was performed. There was a rigid deformity of the MTP joint. After skeletonizing the distal
portion of the metatarsal, an oscillating saw was used to resect the distal portion of the second
metatarsal. Fluoroscopy was used to guide the osteotomy. I then remove the distal portion of the
metatarsal shaft and metatarsal head. After this I made a second incision transversely over the
PIP joint. I skeletonized the PIP joint and then used a rondure to resect the distal portion of
the proximal phalanx. After this was done, I lavaged both wounds and then placed a 0.062 Kirschner
pin from a proximal to distal direction out through the tip of the toe followed by retrograde
distal to proximal pinning of the metatarsal shaft. Three-view x-ray showed that the pin was
intramedullary and that the toe is well aligned.