Orthopedic Coding Questions June 21, 2012-06-06
Question
1. Code the appropriate procedure. Endoscopic anterior and posterior capsule labrum reconstruction with removal large loose body, labrum chondroplasty, glenohumeral debridement.
2. Massive complete rotator cuff, markedly retracted, irreparable very retracted atrophied and unable to be repaired. Scope was unable to advance and the greater tuberosity was large and irregular, removing soft tissue and bone from this area. The subacromial space is decompressed; we left the CA ligament intact, removed inferior spurring and debris. The bursa was debrided. This was also non-mobile. AC joint outlined with a light wave and then a burr was utilized to remove 1cm of the distal clavicle.
A. How many independent procedures were performed?
B. Give the CPT Codes.
3.DIAGNOSIS: Septic arthritis, right elbow.
PROCEDURE: Irrigation and debridement of septic bursitis right elbow with a complete en bloc excision in entirety of the olecranon bursa as well extensive debridement of the deep abscess tracking proximally along the triceps musculature for length of 10 cm and tracking distally along the volar and dorsal musculature and subcutaneous tissue approximately20 cm. Give the appropriate CPT CODE.
4. DIAGNOSIS: Right wrist dislocation status post reduction now with avascular necrosis of scaphoid and lunate and severe contracture. Severe contracture of index, middle, ring, and small finger secondary to complex pathology including Scarring of extensor mechanism, contracture of the PIP joint and contracture of intrinsic mechanism.
Procedures Performed:
Right wrist proximal row corpectomy
RT wrist extensor tendon extensive tenosynovectomy and tenolysis
RT index finger proximal interphalangeal joint capsulotomy and release of collateral ligament
RT index finger extensor mechanism tenolysis
RT index finger distal intrinsic tendon release
RT middle finger extensor tendon tenolysis
RT Middle finger distal intrinsic tendon release
Rt Middle finger PIP joint capsulotomy
Rt. Ring finger extensor tendon tenolysis
RT ring finger PIP joint capsulotomy
RT ring finger distal intrinsic release
RT small finger extensor tendon tenolysis
RT small finger proximal interphalangeal join capsulotomy
RT small finger distal intrinsic release
Given the procedure mentioned above:
A. How many independent procedures were performed?
B. Give the CPT Codes.
5.DIAGNOSES: Right foot hallux rigidus. Second, third, and fourth claw toe deformity. Extensor digitorum longus and brevis contracture, second toe metatarsophalangeal joint
GIVE THE FOLLOWING CPT FOR PROCEDURE PERFORMED.
a. Great toe proximal phalanx dorsal closing wedge osteotomy.
b. First metatarsophalangeal joint cheilectomy, removal of loose body and extensive capsule release and chilectomy.
c. Second toe extensor digitorum longus lengthening with arthrotomy and collateral ligament release of second metatarsophalangeal joint.
d. Distal condylar excision, proximal phalanx, second toe, with interposition arthroplasty.
e. Third, fourth and fifth toe flexor digitorum longus to extensor digitorum longus tendon transfer.