In such cases, the surgeon will insert an intervening prosthetic material (autograft, allograft, xenograft or synthetic), which involves attachment of the graft to the surrounding tissues in addition to the routine vaginal repair(s). It's not uncommon for the native tissues to be weak and inadequate for repair, especially in patients who have had previous attempts at repair. Next we discuss reconstructive procedures performed for the anterior and posterior compartments of the vagina. The fixator was then fixed in place using the bar and more X-rays were taken.Ģ5605-LT Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed with manipulationĢ0690 Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system The wrist was visually reduced and good reduction was verified on both AP and lateral X-rays. The Synthes external fixator set was used for this procedure. Under fluoroscopic guidance, proximal pins were then placed in the usual fashion at about the mid level of the radius, again using the same sequence. PROCEDURE: Under general anesthesia, 2 distal pins were placed on the second metacarpal shaft under direct visualization with care to dissect down to the bone. There are 3 directions of planes, assuming the person being examined is standing and facing the examiner: vertical anterior to posterior (sagittal), vertical side to side (coronal or longitudinal) and horizontal (transverse).ĭIAGNOSIS: Left comminuted impacted distal radius fracture Use code 20692 when you apply a multiplane external fixation system. Use code 20690 when you apply pins or wires in 1 plane, unilaterally, as an external fixation device. Use codes for external fixation only when external fixation is not already listed as part of the basic procedure.Ģ0690: Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation systemĢ0692: Application of a multiplane (pins or wires in more than 1 plane), unilateral, external fixation system (e.g., Ilizarov, Monticelli type) The external fixation is then no longer needed and can be safely removed. When the fracture is stable or healed, all forces are borne by the bone. As the fracture callus (formation of new bone around a fracture site) begins to consolidate, more load will be shared by the bone fragments. Here's a review.Įxternal fixation is based on the principle of "load transference." Forces normally transmitted through the fracture site are bypassed through the external fixator frame and pin/bone interface at an early stage of treatment. But the CPT code book also contains specific guidelines that require a code for both the procedure and the device or implant when you apply an external fixator, pelvic floor defect mesh/prosthesis or GraftJacket during surgery. We all know about the opportunities that exist when you bill HCPCS Level II codes for implants or devices that are inserted during surgery.
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