DavitaBrannon03
Contributor
I have some questions on how to approach a recent revision that my podiatrist performed.
Below is a breakdown of what was performed.
Please note that this is a revision procedure and hardware was removed (20680).
Ankle fusion
-K-wire fixation of the subtalar joint (anterior approach) that extended into the tibiotalar joint and ended in the distal tibia (x2)
-K-wire fixation of the subtalar joint (lateral approach) that extended into the fibulotalar joint and ended in the distal fibula (x1)
Midtarsal fusion
(this is from the note) Once we had solid fixation of her rear foot we addressed the midfoot deformity. We resected the midtarsal joint talonavicular joint, as well as, the calcaneocuboid joint with an oscillating saw...we wedged the bone to allow us to place her foot into a neutral position...we pinned 2 K wires across the medial cuneiform and navicular into the calcaneal body at an oblique angle due to the fact that we did find a stress fracture riser to the talar body after placing her large screw fixation. We also placed a K wire across from the cuboid bone into the calcaneal body. Once we resected and pinned our midtarsal joint in the proper position with the foot at neutral we inserted 4.0 cannulated screws to compress these joints for fusion and we also packed it with DBM and bone chips to allow for fusion. We decided to place a medial plate spanning the tibia midtarsal joint on the meidal side due to the fact that the talus had a stress riser and fracture to give extra stability and rigidity to the construct and to allow fusion. Placed the plate spanning the navicular and medial cuneiform...
Here is what I have so far, but I can't find a code that exists for the fibulotalar fusion and I'm not sure if I am looking at this correctly or not.
28715-triple fusion (talonavicular, calcanoecuboid, subtalar)
28740-single fusion (medial cuneiform navicular)
27870-ankle (tibiotalar) fusion
20680-hardware removal
Any help with this is very appreciated.
Below is a breakdown of what was performed.
Please note that this is a revision procedure and hardware was removed (20680).
Ankle fusion
-K-wire fixation of the subtalar joint (anterior approach) that extended into the tibiotalar joint and ended in the distal tibia (x2)
-K-wire fixation of the subtalar joint (lateral approach) that extended into the fibulotalar joint and ended in the distal fibula (x1)
Midtarsal fusion
(this is from the note) Once we had solid fixation of her rear foot we addressed the midfoot deformity. We resected the midtarsal joint talonavicular joint, as well as, the calcaneocuboid joint with an oscillating saw...we wedged the bone to allow us to place her foot into a neutral position...we pinned 2 K wires across the medial cuneiform and navicular into the calcaneal body at an oblique angle due to the fact that we did find a stress fracture riser to the talar body after placing her large screw fixation. We also placed a K wire across from the cuboid bone into the calcaneal body. Once we resected and pinned our midtarsal joint in the proper position with the foot at neutral we inserted 4.0 cannulated screws to compress these joints for fusion and we also packed it with DBM and bone chips to allow for fusion. We decided to place a medial plate spanning the tibia midtarsal joint on the meidal side due to the fact that the talus had a stress riser and fracture to give extra stability and rigidity to the construct and to allow fusion. Placed the plate spanning the navicular and medial cuneiform...
Here is what I have so far, but I can't find a code that exists for the fibulotalar fusion and I'm not sure if I am looking at this correctly or not.
28715-triple fusion (talonavicular, calcanoecuboid, subtalar)
28740-single fusion (medial cuneiform navicular)
27870-ankle (tibiotalar) fusion
20680-hardware removal
Any help with this is very appreciated.