Wiki Aspiration of Seroma Breast CPT Help

[Joyce Burchett]

Patient in post-op of bilateral total mastectomy in March & drain removal April 6th. Dr. is now doing an aspiration of the seroma in the office procedural room. Prepped & draped RT mastectomy site & infiltrated the skin under the mastectomy incision with 1% lidocaine with epi. A stab incision was made in the skin with an #11 blade. Inserted the seroma catheter & needle under direct ultrasound visualization. Images captured & stored. Once straw colored fluid was seen in the catheter, the needle was removed & 50 cc of clear seroma fluid was drained from the cavity. Next, the cavity was flushed with 250 cc of saline. The irrigant was completely aspirated from the mastectomy cavity. Then, I expanded the cavity with 70% ethanol until the patient complained of mild discomfort. The catheter was clamped & patient was left laying suspine for 40 minutes. After this time the ethanol from the cavity was completely aspirated until the mastectomy flap is flushed with her pectoralis muscle. A post-procedural US was obtained to confirm complete collapse of the cavity. The catheter was withdrawn & the catheter puncture wound was covered with a band-aid. Would this be billable with CPT 49185 or is this 10030, 10140, or 10160. Can you charge ultrasound separately if you use 10140 or 10160?

 

[sscott@hogonc.com]

Or is this considered bundled into the Global surgery package?

 

[hope7531]

Patient in post-op of bilateral total mastectomy in March & drain removal April 6th. Dr. is now doing an aspiration of the seroma in the office procedural room. Prepped & draped RT mastectomy site & infiltrated the skin under the mastectomy incision with 1% lidocaine with epi. A stab incision was made in the skin with an #11 blade. Inserted the seroma catheter & needle under direct ultrasound visualization. Images captured & stored. Once straw colored fluid was seen in the catheter, the needle was removed & 50 cc of clear seroma fluid was drained from the cavity. Next, the cavity was flushed with 250 cc of saline. The irrigant was completely aspirated from the mastectomy cavity. Then, I expanded the cavity with 70% ethanol until the patient complained of mild discomfort. The catheter was clamped & patient was left laying suspine for 40 minutes. After this time the ethanol from the cavity was completely aspirated until the mastectomy flap is flushed with her pectoralis muscle. A post-procedural US was obtained to confirm complete collapse of the cavity. The catheter was withdrawn & the catheter puncture wound was covered with a band-aid. Would this be billable with CPT 49185 or is this 10030, 10140, or 10160. Can you charge ultrasound separately if you use 10140 or 10160?

Do you have any more info on this, I have a similar situation and leaning toward billing 10140 with 76942.