codedog
True Blue
I only have little documentation on this, confused on using 62230 or 49426, could someone point me in the right direction
Provider was revising a ventriculoperitoneal shunt and was having a hard time getting the distal catheter into the peritoneum, so he called for assistance. Another provider went in from the open the incision . Using retractors it was determined that there was a lot of adhesions to the intraabdominal wall preventing entrance into the peritoneal cavity. Using a finger dissection and sharp dissection , was able to create a space where at least a10 -mm trocar into the abdominal cavity. CO2 insufflation followed, but it was difficult to distend the abdomen as there was a lot of leakage of CO2 BACK through the upper right quadrant incision. . Using an angled 5mm telescope, was able to visualize the space in the lower abdomen that was appropriate for the cathether.. Then next to the 10 mm trocar , provider manipulated adilator and peel -away sheath into that space and then removed the trocar and placed peritoneal portion of the shunt through the peel-away sheath and peeled the sheath. . Repeat laparoscopy confirmed that the tubing was in the lower abdominal space . .The trocar was removed. The fascia was closed using 2-0 Vicryl sutures. Subcutaneous tissues was also closed with 2-0 sutures . Skin was closed with Monocryl.
62230 or 49426 , please help , Thanks
Provider was revising a ventriculoperitoneal shunt and was having a hard time getting the distal catheter into the peritoneum, so he called for assistance. Another provider went in from the open the incision . Using retractors it was determined that there was a lot of adhesions to the intraabdominal wall preventing entrance into the peritoneal cavity. Using a finger dissection and sharp dissection , was able to create a space where at least a10 -mm trocar into the abdominal cavity. CO2 insufflation followed, but it was difficult to distend the abdomen as there was a lot of leakage of CO2 BACK through the upper right quadrant incision. . Using an angled 5mm telescope, was able to visualize the space in the lower abdomen that was appropriate for the cathether.. Then next to the 10 mm trocar , provider manipulated adilator and peel -away sheath into that space and then removed the trocar and placed peritoneal portion of the shunt through the peel-away sheath and peeled the sheath. . Repeat laparoscopy confirmed that the tubing was in the lower abdominal space . .The trocar was removed. The fascia was closed using 2-0 Vicryl sutures. Subcutaneous tissues was also closed with 2-0 sutures . Skin was closed with Monocryl.
62230 or 49426 , please help , Thanks