Removal of Loose Body PIP jt

What CPT for the above? I can't decide between 26160 and 26080. The op note reads: Attention was turned to the dorsal aspect of the middle finger PIP jt where a longitudinal incision was made. Subcutaneous tissues were divided. The common extensor tendon was spread in line with its fibers and a 7mm x 5mm intraaticular loose body was removed.
Would this be considered an arthrotomy? Thanks,

Comments

  • edited May 2017
    If the PIP jt was opened, it was an arthrotomy. 26080 would be the code.
  • edited May 2017
    I'm in Missouri, WPS is our carrier, we do need to report the physician treating the systemic disease and include their last date of service with that doc to get paid. and this is what they say:

    Systemic Conditions
    Foot care services are covered in the presence of a systemic condition based on the list of illnesses described in Chapter 15, Section 290 of the Benefit Policy Manual.

    Diabetes mellitus *
    Arteriosclerosis obliterans (A.S.O., arteriosclerosis of the extremities, occlusive peripheral arteriosclerosis)
    Buerger’s disease (thromboangiitis obliterans)
    Chronic thrombophlebitis *

    Peripheral neuropathies involving the feet -
    Associated with malnutrition and vitamin deficiency *
    Malnutrition (general, pellagra)

    Alcoholism

    Malabsorption (celiac disease, tropical sprue)

    Pernicious anemia

    Associated with carcinoma *
    Associated with diabetes mellitus *
    Associated with drugs and toxins *
    Associated with multiple sclerosis *
    Associated with uremia (chronic renal disease) *
    Associated with traumatic injury
    Associated with leprosy or neurosyphilis
    Associated with hereditary disorders
    Hereditary sensory radicular neuropathy

    Angiokeratoma corporis diffusum (Fabry’s)

    Amyloid neuropathy

    When the patient’s condition is one of those designated by an asterisk (*) above, routine procedures are covered only if the patient is under the active care of a doctor of medicine or osteopathy who documents the condition.

    The active care requirement would be considered met if the claim indicates that the patient has seen an M.D. or D.O. for treatment and/or evaluation of the complicating disease process during the 6-month period prior to the service.
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