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Old 07-18-2011, 11:26 AM
kimed34 kimed34 is offline
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Default Thoracotomy with excision of duplication cyst

Does anyone know what code should be used for a Thoroactomy with excision of duplication cyst?

Operative report states it was performed for a large cystic mass partially adherent to the esophageal wall with significan splaying of the esophagus.
Transverse incision was made and a muscle-sparing thoracotomy was then performed mobilizing the lattismus posteriorly and the serratus anteriorly. The 3rd intercostal space was opened. The finochietto rib spreaders were then placed in opposing directions to facilitate access. Lung was retracted medially and esophagus was identified by the orogastric tube. Meticulous dissection was then carried out visualizing the esophagus, creating a dissection place from the cyst.....the cyst was then entered and a significant amount of mucoid and clear fluid was evacuated, this facilitated exposure. sequentially then the cyst was dissected....the mass was then dissected away from the esophagus. The thoracic inlet was reached, care taken to avoid injury to great vessels. ...Cyst was completedly exised and delivered from the field. Inspection of the esophagus showed no perforation. ....Lungs then reexpanded. Ribs closed, skin closed.
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Old 07-27-2011, 11:52 AM
jewlz0879 jewlz0879 is offline
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Quote:
Originally Posted by kimed34 View Post
Does anyone know what code should be used for a Thoroactomy with excision of duplication cyst?

Operative report states it was performed for a large cystic mass partially adherent to the esophageal wall with significan splaying of the esophagus.
Transverse incision was made and a muscle-sparing thoracotomy was then performed mobilizing the lattismus posteriorly and the serratus anteriorly. The 3rd intercostal space was opened. The finochietto rib spreaders were then placed in opposing directions to facilitate access. Lung was retracted medially and esophagus was identified by the orogastric tube. Meticulous dissection was then carried out visualizing the esophagus, creating a dissection place from the cyst.....the cyst was then entered and a significant amount of mucoid and clear fluid was evacuated, this facilitated exposure. sequentially then the cyst was dissected....the mass was then dissected away from the esophagus. The thoracic inlet was reached, care taken to avoid injury to great vessels. ...Cyst was completedly exised and delivered from the field. Inspection of the esophagus showed no perforation. ....Lungs then reexpanded. Ribs closed, skin closed.

What about 32140; thoracotomy with cyst(s) removal, with or without pleural procedure. That might fit pretty well...
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