bwilliams31
Guest
The patient was brought into the operating room.
He was laid in the supine position. He was prepped and draped in the usual fashion. As I mentioned in my history and physical he did have a draining sinus tract in the midline of his scrotum right at the previous vasectomy and spermatocelectomy incision scar. This tracked down to the region of where the right vasectomy and then subsequent sperm granuloma resection occurred. I incised the scrotum in an elliptical
fashion around the sinus tract. This was about 1 cm in size. I then cut
through the skin and then placed a Kocher clamp on the sinus tract and using very careful blunt palpation I dissected this sinus tract free all the way down to the cord where it attached to the vas. I went completely around it and removed all the inflammatory tissue. At the end of the procedure I could not palpate any other granulation tissue. There was no bleeding. I then returned all the structures to their normal place in the scrotum. I closed the scrotum in two layers using a 3-0 Chromic suture for
the subcutaneous layer and a 4-0 Monocryl subcuticular for the skin. The
patient tolerated the procedure well. He was taken back to the recovery room in stable condition.
please help the office coded as 54512 I disagree with this I was thinking 55899/61.42 please help thank you in advance
He was laid in the supine position. He was prepped and draped in the usual fashion. As I mentioned in my history and physical he did have a draining sinus tract in the midline of his scrotum right at the previous vasectomy and spermatocelectomy incision scar. This tracked down to the region of where the right vasectomy and then subsequent sperm granuloma resection occurred. I incised the scrotum in an elliptical
fashion around the sinus tract. This was about 1 cm in size. I then cut
through the skin and then placed a Kocher clamp on the sinus tract and using very careful blunt palpation I dissected this sinus tract free all the way down to the cord where it attached to the vas. I went completely around it and removed all the inflammatory tissue. At the end of the procedure I could not palpate any other granulation tissue. There was no bleeding. I then returned all the structures to their normal place in the scrotum. I closed the scrotum in two layers using a 3-0 Chromic suture for
the subcutaneous layer and a 4-0 Monocryl subcuticular for the skin. The
patient tolerated the procedure well. He was taken back to the recovery room in stable condition.
please help the office coded as 54512 I disagree with this I was thinking 55899/61.42 please help thank you in advance