Arthroplasty

“The original procedure that was performed was a hallux interphalangeal joint arthroplasty to resolve a medial, diabetic ulcer. An infection developed that led to a hallux amputation. Does the global of the first surgery (arthroplasty) stay in place or is it reset by the zero-day global for the second surgery (amputation)?”

“I have a patient with a possible 1st proximal phalanx cyst vs infection that I plan to do an exploratory procedure and collect some bone cultures / swabs on. MRI was inconclusive. If I get in there and the bone appears necrotic/infected, I will have on the consent form to allow for a PIPJ arthroplasty. So, we'll get prior auth for all these procedures prior to surgery. But, for the initial planned procedure, how would this be coded?”

“In many cases requiring an arthroplasty of the proximal interphalangeal joint (PIPJ) 5th digit (especially when associated with a heloma molle), I often do an arthroplasty PIPJ, flexor lengthening and a partial syndactylization (advancing the webspace but differently than the description of Ruiz-Mora). I have always simply billed for an arthroplasty PIPJ 5th toe. Now I have been forced to pay attention to coding because of my EMR program. Should I have been billing this differently for all these years?”