The American College of Surgeons recommends 35820 for post-operative hemorrhage after breast surgery but after reviewing the RVUs, I'm wondering if this is the correct code for the following scenario:
OPERATIVE FINDING: Clot over the entire right chest wall and laterally within the entire right side of the wound. Skin flaps and muscle were found to be dry. She was oozing from multiple surfaces in the subcutaneous fat, anterior to the laissimus dorsi, and from the lateral chest wall. There is no single source.
EXCERPT FROM PROCEDURE:
...Drain stitches were removed, and the rest of the drains were removed from under the skin flaps. The staples were removed from just to the right of midline and laterally to about 3 cm before the end of the incision. Vicryl sutures in the subdermal space were cut. Using suction and manual decompression, the free blood and the clot were removed. Careful inspection of all surfaces was performed. Cautery was applied for hemostasis where appropriate. The wound was irrigated. Reinspection showed some bleeding in the upper lateral portion of the wound and clips were applied to tissue that seemed to have an isolated spot of oozing. Two new Jackson-Pratt drains were placed, one laterally and one anteriorly. There were sutured in position with 3-0 Nylon sutures. The wound edges were reapproximated with interruped subdermal sutures of 4-0 Vicryl. Skin was closed with staples.
Others in other forums have suggested 10140 & 21501 for hematomas. Does anyone have any suggestions?
Thanks-Sue
OPERATIVE FINDING: Clot over the entire right chest wall and laterally within the entire right side of the wound. Skin flaps and muscle were found to be dry. She was oozing from multiple surfaces in the subcutaneous fat, anterior to the laissimus dorsi, and from the lateral chest wall. There is no single source.
EXCERPT FROM PROCEDURE:
...Drain stitches were removed, and the rest of the drains were removed from under the skin flaps. The staples were removed from just to the right of midline and laterally to about 3 cm before the end of the incision. Vicryl sutures in the subdermal space were cut. Using suction and manual decompression, the free blood and the clot were removed. Careful inspection of all surfaces was performed. Cautery was applied for hemostasis where appropriate. The wound was irrigated. Reinspection showed some bleeding in the upper lateral portion of the wound and clips were applied to tissue that seemed to have an isolated spot of oozing. Two new Jackson-Pratt drains were placed, one laterally and one anteriorly. There were sutured in position with 3-0 Nylon sutures. The wound edges were reapproximated with interruped subdermal sutures of 4-0 Vicryl. Skin was closed with staples.
Others in other forums have suggested 10140 & 21501 for hematomas. Does anyone have any suggestions?
Thanks-Sue