cclarson
Guru
Hello Everyone, Can anyone help me understand how to code this one? I know how to code a syndactyl, but I'm not sure how to code the arthroplasty. I would deeply appreciate any help. Thank you!
POSTOPERATIVE DIAGNOSIS:
Chronic painful corn between fourth and fifth toe, right foot.
OPERATIONS PERFORMED:
1. Arthroplasty of the fifth toe.
2. Syndactyly of the fourth to fifth toe.
DESCRIPTION OF PROCEDURE:
The patient was brought into the OR and placed supine on the table. General anesthesia was initiated. The foot was prepped and draped to the knee in a normal sterile fashion. The tourniquet was inflated. Attention was directed to the fourth and fifth toes. A curvilinear incision was created over the dorsolateral aspect of the fifth toe of about 3 cm in length. It was deepened to the deep fascia. The extensor tendon was transected and reflected proximally. The head of the proximal phalanx was then resected with a bone cutting forceps. The bone was removed, and the stump of the bone was rasped with a bone rasp. The wound was flushed with sterile saline. The extensor tendon was repaired with 3-0 Vicryl, and the skin was repaired with simple interrupted 4-0 nylon suture. Attention was then directed to the fourth interdigital space where 2 converging semielliptical incisions were created in the interspace. The skin ellipse was removed. The repair was completed with 4-0 chromic suture. The above-noted amounts of local anesthetic were then injected to the fourth and fifth toes. The foot was bandaged with Xeroform gauze, dry sterile dressing, Kling, and Coban. The patient left the OR in stable and satisfactory condition. He will be discharged to recovery and follow up in Dr. Hamilton's office in 1 week.
POSTOPERATIVE DIAGNOSIS:
Chronic painful corn between fourth and fifth toe, right foot.
OPERATIONS PERFORMED:
1. Arthroplasty of the fifth toe.
2. Syndactyly of the fourth to fifth toe.
DESCRIPTION OF PROCEDURE:
The patient was brought into the OR and placed supine on the table. General anesthesia was initiated. The foot was prepped and draped to the knee in a normal sterile fashion. The tourniquet was inflated. Attention was directed to the fourth and fifth toes. A curvilinear incision was created over the dorsolateral aspect of the fifth toe of about 3 cm in length. It was deepened to the deep fascia. The extensor tendon was transected and reflected proximally. The head of the proximal phalanx was then resected with a bone cutting forceps. The bone was removed, and the stump of the bone was rasped with a bone rasp. The wound was flushed with sterile saline. The extensor tendon was repaired with 3-0 Vicryl, and the skin was repaired with simple interrupted 4-0 nylon suture. Attention was then directed to the fourth interdigital space where 2 converging semielliptical incisions were created in the interspace. The skin ellipse was removed. The repair was completed with 4-0 chromic suture. The above-noted amounts of local anesthetic were then injected to the fourth and fifth toes. The foot was bandaged with Xeroform gauze, dry sterile dressing, Kling, and Coban. The patient left the OR in stable and satisfactory condition. He will be discharged to recovery and follow up in Dr. Hamilton's office in 1 week.