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Anesthesia Coding Alert

Reader Questions:

OR Report Will Point to 00472 or 00540 for Pectoralis Flap Closure

Published on Mon May 02, 2011

Question:The anesthesia record documents a pectoralis flap reconstruction that included debridement of sternal wound infection, removal of sternal wires, and muscle flap closure. What are the best surgical and anesthesia codes? New Mexico Subscriber Answer: The surgeon's report will give more details about the best codes, but one possibility could be 21742 (Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach [Nuss procedure], without thoracoscopy). If the physician noted a diagnosis of empyema (510.x, Empyema), you might consider 32810 (Closure of chest wall following open flap drainage for empyema [Clagett type procedure]).Code 21742 crosses to anesthesia code 00472 (Anesthesia for partial rib resection; thoracoplasty [any type]), with 10 base units. Code 32810 crosses to anesthesia code 00540 (Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum [including surgical thoracoscopy]; not otherwise specified), with 12 base units.
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