mardi 23 juin 2015

help totally confused

I am not seeing the internal fixation for the dislocations but I feel like I am missing another code???

I have 28270 and 28285

3/4 inch incision was made centered over the second MTP joint. Dissection continued through subcutaneous tissue. Capsulotomy was performed. There was some arthritis and contracture of the articulation. Soft tissue release was used to reduce the pathological dislocation and release the contracture. Base of the proximal phalanx was removed in order to shorten the toe and reduce the contracture and extensor tendon rebalancing was done to afford a new resting balance length. An elliptical incision was made through the skin, tendon, down to bone on the dorsum of the second PIP joint and hammertoe correction was performed as a soft tissue release. The proximal phalangeal head was resected using the micro sagittal saw carefully to release the contracture and to release the pathological dislocation of the PIP joint. At this point , a K wire was driven from the MTP joint out to the tip of across the PIP joint and then ante grade through the MTP joint to affix the toe into its new position.

Any help or suggestions would be appreciated.
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help totally confused

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