ICD 10 PCS code needed

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ICD 10 PCS code needed

Icd 10 Pcs Code Needed 1 (134.16 KiB) Viewed 39 times

he OR table with all of extremity and a closed were found to reduce. cture pattern, I thought en placed under direct s avoided. The fracture me pins were noted to be ssings followed by sugar g on this case. at seen for neurosurgical e on a trampoline in high In addition, he was in an or 3 to 4 weeks and pain nflammatory medications, and felt worse afterwards. mbness of his neck and the inction well. The risks and action, and he desired that theatre and endotracheal shoulders. His head was skin lines, horizontally in of the vertebral column. at the C5-C6 level. Self- zed. A portion of the disc t disc material was present ch was now fully exposed h with the use of the oper matomal somatosensory asion device was chosen to as placed firmly into posi yl with Dermabond on the well and will be cared for Check Your Understanding 359 1. Left scaphoid nonunion. Operative Report PREOPERATIVE DIAGNOSIS: 2. Left wrist posttraumatic osteoarthritis. 3. Left wrist pain. Same 1. Left wrist proximal row carpectomy. POSTOPERATIVE DIAGNOSIS: PROCEDURE: 2. Left radial styloidectomy. 3. Left wrist posterior interosseous neurectomy. INDICATIONS: Patient is a 73-year-old right-hand-dominant male, who sustained a fall and presented to me approximately six weeks ago with persistent left wrist pain. Patient had a scaphoid nonunion. Patient was treated in a cast and he still had significant amount of pain and patient wanted pain-free range of motion. I explained to him risks and benefits of scaphoid excision and a four-corner fusion versus a proximal row carpectomy and the patient elected for a proximal row carpectomy. I also explained that doing a radial styloidectomy would help with his range of motion and doing a neurectomy would help as well. Risks and benefits were explained to the patient and the patient wished to proceed with surgery. PROCEDURE: Patient was identified in the preoperative area and the left upper extremity was confirmed with the patient and marked. In the OR, under general anesthesia, left upper extremity nonsterile arm tourniquet was applied. The left upper extremity was prepped and draped in the usual sterile fashion. Time-out was per- formed. Antibiotics 1 gram of Ancef was given. Incision was marked out over the dorsal aspect, centered over the radiocarpal joint just ulnar to Lister's tubercle and approximately a 7-cm incision was marked out. The left upper extremity was exsanguinated with an Esmarch bandage. Tourniquet was inflated to 250 mmHg. Incision was made directly over the radiocarpal joint that was previously drawn out and superficial dissection was performed with a blunt right-angle clamp and hemostasis was achieved with bipolar electrocautery. The fourth dorsal compartment was retracted toward the ulnar at the fourth compartment. The posterior interosseous nerve was identified and approximately 3-cm segment was excised and the proximal stump was cauterized with Bovie electrocautery. were all Arthrotomy was then performed and the scaphoid, lunate, and triquetrum were identified. The scapholunate ligament t was incompetent. The scaphoid nonunion was also visualized. Scaphoid, lunate, and the triquetrum were all removed in a piecemeal fashion without significant difficulty. The bone was very soft. The articular sur- tice over the capitate and also over the lunate facet was intact and there were no signs of osteoarthritis noted over the lunate fossa of the distal radius. The radial styloid was identified and using the osteotome, approxi- s confirmed and mately 4-mm segment of the styloid was excised. C-arm at that time was brought in and it the wrist was placed through a range of motion and the carpus was stable. There was no impingement of the our the the trapezium on the styloid. and the retinaculum was closed over the fourth dorsal compartment with Z-plasty with 2-0 Vicryl suture. Wound was copiously irrigated and the capsule was reapproximated with 0-Vicryl figure-of-eight suture Approximately 30 mL of 0.25% plain Marcaine was injected for postoperative pain relief. The subcutaneous tasue was reapproximated with 2-0 Vicryl inverted suture and the skin was reapproximated with 3-0 nylon horizontal mattress sutures.