exploration

  1. L

    Wiki Expanding chest wall mass exploration

    Hello. Stuck on this one. I'm not sure what to even code here, or how. Procedure as follows: PREOPERATIVE DIAGNOSIS/DIAGNOSES Remote history of coronary artery bypass grafting, recent fall, mediastinal mass. POSTOPERATIVE DIAGNOSIS/DIAGNOSES Remote history of coronary artery bypass...
  2. J

    Wiki Need Guidance on When Wound Closure Codes Reportable with Exploration Codes

    Hello, I'm still new to coding and am finding it difficult to know when wound closure is separately reportable from wound exploration (and when it isn't). For example, I had a neck stabbing that required exploration and a complex closure, and I was told to report 20100 for exploring the wound...
  3. L

    Spinal Hardware Removal

    If the surgeon removes fusion hardware at the L4(locking cap, portion of rod, tulip head, and pedicle screw) in a patient with a history of fusion L4 - S1 can we code 22830 for Exploration of Fusion? During the procedure, the surgeon states "The fusion bed at this level appeared to be robust...
  4. N

    Wiki Exploration and debridement of nonhealing abdominal wound?

    I need help with a CPT code. I will attach the OP report. He wanted to bill 20102 and I know that is incorrect but I couldn't find anything else to bill. Any pointers? PROCEDURE: Exploration and debridement of nonhealing abdominal wound. Excision of abdominal stitch abscess...
  5. S

    Wiki Exploration upper extremity-HELP!

    Hi there, Doctor did an exploration of the RT Upper Extremity thinking there would be a mass that he would excise. When he got in there he found that it was dilation of vein that was adherent to deeper structures. He closed it and is referring the patient to a vascular surgeon. I am not sure how...
  6. R

    Wiki Biceps tendon exploration

    Surgery was scheduled for bicep tendon repair based upon MRI. However, when the surgeon got in there a tear was not found so all that was done was an exploration. I need help with the CPT for that. We originally filed this as unlisted and compared to 24341 but Cigna denied and tells us...
  7. D

    Wiki The most complicated 2-paragraph op report EVER.

    OK, A total hip arthroplasty is being done on a 90 yr old woman (??). During this op, she starts bleeding out. There are no vascular sugeons available (this is a rural hospital and there are unfortunates gaps in the specialist call schedules), so my Doc, who is a General Surgeon, is called in to...
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