Forum - Questions & Answers

Mar 20th, 2015 - jburchett 2 

Revision Burton Arthroplasty w/placement Arthrex Mini TightRope

Pt had a previous burton arthroplasty 6 months ago. Previously coded 25447 & 25310. Now having thumb & wrist pain & x-ray shows subluxation of the metacarpal to the scaphoid. Dissection carried down bluntly through skin & the capsule identified. Division was carried down & the old FCR tendon graft was noted. This appeared to be bulging out away from the metacarpal-scaphoid junction. Tendon was dissected away from surrounding area. There appeared to be enough trapezoid in close proximity that some rongeuring was performed to prevent impingement. ROM was performed, the mini C-arm used to visualize that there was no adjacent bone to the scaphoid. Next the Arthrex Mini TightRope system was opened & a 0.062 K-wire was passed through the 2nd metacarpal at the base. Thumb was in distraction & slight pronation when this was placed. Next the guidewire was passed through there with the suture in place. Positioning of the wire was checked with C-arm prior to placing this suture as well. Next, the metal button on the ulnar side of the 2nd metacarpal was placed oth the suture wire as well. The knot was covered with interosseous muscle & fascial plane. C-arm was checked. Good distraction & positioning noted. The excess tendon was then placed down into the bony defect & capsule was closed. Thumb spica splint was placed.
Question: Do you code 25447 again or do we use an unlisted 26989 & compare to 25447 or does anyone know how to code this procedure?

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