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Hello,
Can someone please help me coding this GYN robotic surgery:
Attention was then turned to the surgeon’s console. The above findings were noted. Right ovarian fossa endometriosis was excised. Right ureterolysis was performed. Large bowel adhesions to the pelvic brim were lysed. Left ovarian fossa endometriosis was excised and left ureterolysis was performed. Bilateral uterosacral ligament endometriosis was excised. An EEA sizer was paced into the rectum so the rectovaginal, rectum and peri-rectal fossa endometriosis excised. Bladder was filled in a retrograde manner with sterile saline to help identify bladder edge. Excision of the endometrial implants attached to the peritoneum was performed. Each specimen was retrieved through the LUQ port, and was labled appropriately. The specimens were sent to pathology for evaluation. See above specimen list for location of all excised tissue. Warm normal saline was utilized for irrigation and all debris and clots was cleared from abdomen.
Excision of endometriosis in the posterior cul de sac and peri-rectal fossa led to concerns for large bowel intactness. Rectal integrity was tested. Attention was turned to the anal sphincter. A 30 French foley catheter was introduced into the rectum. The foley balloon was inflated with 30 cc of sterile saline. A Toomey syringe was used to infuse the rectum, sigmoid colon and descending colon with sterile blue saline while the pelvis was monitored laparoscopically. No leakage of blue fluid was noted from the bowel.
It looks like a lot, however I think I can only code the 58662, Excision of Endometriosis, possibly with a 22 modifier due to the ureterolysis. The rectal integrity test is diagnostic.
I would appreciate any comments!
Can someone please help me coding this GYN robotic surgery:
Attention was then turned to the surgeon’s console. The above findings were noted. Right ovarian fossa endometriosis was excised. Right ureterolysis was performed. Large bowel adhesions to the pelvic brim were lysed. Left ovarian fossa endometriosis was excised and left ureterolysis was performed. Bilateral uterosacral ligament endometriosis was excised. An EEA sizer was paced into the rectum so the rectovaginal, rectum and peri-rectal fossa endometriosis excised. Bladder was filled in a retrograde manner with sterile saline to help identify bladder edge. Excision of the endometrial implants attached to the peritoneum was performed. Each specimen was retrieved through the LUQ port, and was labled appropriately. The specimens were sent to pathology for evaluation. See above specimen list for location of all excised tissue. Warm normal saline was utilized for irrigation and all debris and clots was cleared from abdomen.
Excision of endometriosis in the posterior cul de sac and peri-rectal fossa led to concerns for large bowel intactness. Rectal integrity was tested. Attention was turned to the anal sphincter. A 30 French foley catheter was introduced into the rectum. The foley balloon was inflated with 30 cc of sterile saline. A Toomey syringe was used to infuse the rectum, sigmoid colon and descending colon with sterile blue saline while the pelvis was monitored laparoscopically. No leakage of blue fluid was noted from the bowel.
It looks like a lot, however I think I can only code the 58662, Excision of Endometriosis, possibly with a 22 modifier due to the ureterolysis. The rectal integrity test is diagnostic.
I would appreciate any comments!