Revision Arthrodesis Foot

Would you code this as 28740? I can't find a revision arthrodesis of the foot code. Here is the scenario:

PREOPERATIVE DIAGNOSIS:

1. Failed hardware, right foot.

2. Nonunion arthrodesis, right mid foot.



POSTOPERATIVE DIAGNOSIS:

1. Failed hardware, right foot.

2. Nonunion arthrodesis, right mid foot.



PROCEDURE PERFORMED:

1. Retrieval of failed hardware, right foot.

2. Revision arthrodesis, right foot.





DESCRIPTION OF PROCEDURE:

The patient presented to approximately 1 hour prior to surgery

having been NPO past midnight. The History and Physical and all previous

studies were reviewed with no contraindications to the proposed procedure

identified. An IV was instituted and the patient was taken to the Operating

Room and placed on the operating table in a supine position at which time

general anesthesia was administered. This was supplemented with 1% Lidocaine

to the right ankle. A pneumatic thigh tourniquet was applied to the right

lower extremity. The left lower extremity was then prepped and draped in the

usual aseptic manner. Utilizing elevation and Esmarch bandage the right lower

extremity was exsanguinated and the pneumatic thigh tourniquet inflated to 300

mm of Mercury.



Attention was directed to the right mid foot at which time an incision was

performed overlying the scar from prior surgery. The incision was deepened

through subcutaneous tissues taking care to clamp and cut all bleeders deemed

necessary. This was carried to the level of the periosteum which was incised

and reflected. The failed hardware was identified and retrieved from the

wound. The arthrodesis sites were debrided to healthy bleeding bone.

Following this two cannulated mug screws were utilized, one from

posterolateral through the talus and across the midfoot arthrodesis sites and

one from the dorsal medial talus under C-arm guidance. Prior to final

compression bone graft was placed within the arthrodesis sites. Following this

a claw plate was utilized to further stabilize the navicular cuneiform joint

medially. The C-arm was utilized to do reduction and fixation. Deep tissue

was closed 0 Vicryl in a simple interrupted suture technique. The

subcutaneous tissue was closed with 2-0 Vicryl in a simple interrupted suture

technique. The skin was closed with 3-0 Nylon in a simple interrupted suture

technique. Marcaine 0.5% was infiltrated to the right foot. A mildly

compressive dressing was applied to the right foot and ankle. The tourniquet

was deflated and there was noted to be instantaneous perfusion and hyperemia

to all digits of the right foot.