LTibbetts
Guest
This is the first one of these that I have done. Can anyone tell me if they agree/disagree with my code(s) selection?
Pre/Post op Dx: Bladder cancer
Findings: Pt has over 2.5cm high-grade appearing bladder tumor just above the right ureteral orifice?
Procedure: TURBT and instillation of mitomycin
Op note: "A continuous flow resectoscope was inserted. Careful examination of the bladder was done. Pt only has a solid bladder tumor located just above the right ureteral orifice. Under anesthesia it is clear, but the tumor is falling on the ureter, but it is not involving the ureter. The tumor is systematically resected, and the specimen is taken with an _____*. After completion of the treatment, the _____*, then a foley catheter is inserted, 40mg of mitomycin is instilled, and the catheter is clamped. This will be emptied 1 hour later on the florr. Pt is returned to room...."
I realize that the blanks might be an issue but for right now, this is what I have:
52005 - ?
52235
Dx - 188.5
Pre/Post op Dx: Bladder cancer
Findings: Pt has over 2.5cm high-grade appearing bladder tumor just above the right ureteral orifice?
Procedure: TURBT and instillation of mitomycin
Op note: "A continuous flow resectoscope was inserted. Careful examination of the bladder was done. Pt only has a solid bladder tumor located just above the right ureteral orifice. Under anesthesia it is clear, but the tumor is falling on the ureter, but it is not involving the ureter. The tumor is systematically resected, and the specimen is taken with an _____*. After completion of the treatment, the _____*, then a foley catheter is inserted, 40mg of mitomycin is instilled, and the catheter is clamped. This will be emptied 1 hour later on the florr. Pt is returned to room...."
I realize that the blanks might be an issue but for right now, this is what I have:
52005 - ?
52235
Dx - 188.5