BFAITHFUL
Expert
I have always heard that a fasciotomy using a Topaz Micodebrider was always billed with an unlisted code 28899 because this method uses coblation, but I found this on the AMA website
KB #: 5468
Date: 09/29/2009
Surgery
Musculoskeletal System
Question
What is the appropriate code to report when the -TOPAZ device is used to perform a procedure?
Answer
The TOPAZ MicroDebrider is a tool which utilizes Coblation® technology to perform a small incision in the fascia and is considered an alternative to the use of standard surgical instruments such as scalpels, low frequency electrocautery, and so forth. This technology enables the microdebridement of soft tissue present within the tendons of the knee, shoulder, elbow, ankle and foot. Because the TOPAZ MicroDebrider is a tool and not a procedure, code selection will depend on the service performed, and the specific anatomy involved, as it can be used on different parts of the body. The appropriate code should be selected based on the definitive procedure being performed as described in the code descriptor.
So now I'm not sure what to use. 28008 or 28899. See op note below:
The plantar aspect of the heel was palpated and the area of the symptoms were marked with a series of indelible ink spots going from plantar medial to the plantar lateral proximal aspect to the distal plantar medial to the distal plantar lasteral aspect of the area of pain. These dots were then connected with a series of dots roughly 0.5cm apart until such time there is a grid pattern was created with roughly rectangular in shape. At this time using a 0.062 inch K-wire a percutaneous puncutre wound was made at each of the individual dots from the plantar aspect of the heel, which were previously marked while the patient was still conscious. At this time Topaz coblation device was placed through the puncture wound up to the plantar fascia. The topaz was energized and the Topaz was placed through the plantar fascia. The percutaneous penetration utilizing the Topaz Micrdebrider was repeated and each of the individual puncture sites created with the 0.062 inch K-wire until such time as all puncture sites were done and fasciotomy was completed.
KB #: 5468
Date: 09/29/2009
Surgery
Musculoskeletal System
Question
What is the appropriate code to report when the -TOPAZ device is used to perform a procedure?
Answer
The TOPAZ MicroDebrider is a tool which utilizes Coblation® technology to perform a small incision in the fascia and is considered an alternative to the use of standard surgical instruments such as scalpels, low frequency electrocautery, and so forth. This technology enables the microdebridement of soft tissue present within the tendons of the knee, shoulder, elbow, ankle and foot. Because the TOPAZ MicroDebrider is a tool and not a procedure, code selection will depend on the service performed, and the specific anatomy involved, as it can be used on different parts of the body. The appropriate code should be selected based on the definitive procedure being performed as described in the code descriptor.
So now I'm not sure what to use. 28008 or 28899. See op note below:
The plantar aspect of the heel was palpated and the area of the symptoms were marked with a series of indelible ink spots going from plantar medial to the plantar lateral proximal aspect to the distal plantar medial to the distal plantar lasteral aspect of the area of pain. These dots were then connected with a series of dots roughly 0.5cm apart until such time there is a grid pattern was created with roughly rectangular in shape. At this time using a 0.062 inch K-wire a percutaneous puncutre wound was made at each of the individual dots from the plantar aspect of the heel, which were previously marked while the patient was still conscious. At this time Topaz coblation device was placed through the puncture wound up to the plantar fascia. The topaz was energized and the Topaz was placed through the plantar fascia. The percutaneous penetration utilizing the Topaz Micrdebrider was repeated and each of the individual puncture sites created with the 0.062 inch K-wire until such time as all puncture sites were done and fasciotomy was completed.