Wiki correction of glanular torsion and revision of circumcison

hudsondna

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Help please. I have the following case I need help coding. I came up with 54163 and 14040...

Residual adhesions from the mucosal surface of the prepuce to the
glans penis were bluntly released. The phallus was prepped and
draped in a sterile fashion. A time-out was conducted.
*
A stay suture of 4-0 Tycron was placed into the glans penis to be
utilized as a traction suture. This would ultimately be removed
prior to the conclusion of the surgery.
*
Next, a marking pen was used to describe a circumcising line
about 5 to 6 mm below the glans penis. This line was then
incised. The penile skin was then symmetrically dropped down.
*
Once the phallus had been completely degloved, the orientation of
the urethral meatus was reinspected. It was actually found that
this degloving maneuver had nicely corrected for the glanular
torsion, which had been noted preoperatively. Thus, it was felt
that it would not be necessary to rotate dartos pedicle flap from
the dorsum to the ventrum to assist in giving additional torque
to facilitate detorsion.
*
To improve the postoperative appearance of the phallus and
minimize swelling, a dartos pedicle flap was developed, and that
redundant tissue was excised. Excess preputial tissue was then
removed. The circumcision revision was completed by
reapproximating the penile shaft skin to the mucosal collar with
a series of interrupted sutures using 6-0 Monocryl. At the
frenulum, a horizontal mattress suture was used.

Thanks in advance for the help.
Anita Hudson
 
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