daniel
True Blue
I have an O.P report stating that a Left video-assited thoracoscopic wedge resection of the left lobe was done. CPT 32657.
But at the tail end of the report, he adds.
Upon completion of the surgery, a 28-french chest tube was placed. The incision were closed, however, there was noted to be suddenly a large air leak. The incisions were all reopened. The patient had remained prepped and draped. The camera was reintroduced. Saline was introduced into the chest. Inflation occurred. The lower lobe appeared intact. The upper lobe had very large bubbles and air leak. There were noted to be several blebs along the suture line. Using the 3 incisions and ring forceps, I resected one of these blebs with the Endo GIA times 2 and another bleb with the Endo GIA times 1. The air leak was markedly reduced but still present. I placed ProGel over the incision and placed a 28-French chest tube inside the chest, and the lung reinflated, but it was quite emphysematous and quite thin and friable. There was no other way to suture more material given his known preoperative poor lung function. I placed the 28-french chest tube through the camera port and secured it with 2-0silk. I closed the other incisions with 0 silk, 2-0 vicryl, 4-0 monocyl for skin and dermabond.
Does this documentation warranted adding
CPT 32655:
Thoracoscopy, surgical; with excision-plication of bullae, including any pleural procedure
So are overall coding would look like.
CPT 32657
CPT 32655
Are these services ever done with one another?
Thanks
Daniel,CPC
But at the tail end of the report, he adds.
Upon completion of the surgery, a 28-french chest tube was placed. The incision were closed, however, there was noted to be suddenly a large air leak. The incisions were all reopened. The patient had remained prepped and draped. The camera was reintroduced. Saline was introduced into the chest. Inflation occurred. The lower lobe appeared intact. The upper lobe had very large bubbles and air leak. There were noted to be several blebs along the suture line. Using the 3 incisions and ring forceps, I resected one of these blebs with the Endo GIA times 2 and another bleb with the Endo GIA times 1. The air leak was markedly reduced but still present. I placed ProGel over the incision and placed a 28-French chest tube inside the chest, and the lung reinflated, but it was quite emphysematous and quite thin and friable. There was no other way to suture more material given his known preoperative poor lung function. I placed the 28-french chest tube through the camera port and secured it with 2-0silk. I closed the other incisions with 0 silk, 2-0 vicryl, 4-0 monocyl for skin and dermabond.
Does this documentation warranted adding
CPT 32655:
Thoracoscopy, surgical; with excision-plication of bullae, including any pleural procedure
So are overall coding would look like.
CPT 32657
CPT 32655
Are these services ever done with one another?
Thanks
Daniel,CPC