cubbiecatz
Networker
I need assistance with a CPT code. Everything I have found is in conjunction with a return to the OR. Is there anything we can bill for the cautery of the ovary? Or is the evacuation the only billable procedure?
Procedure(s):
A7 EXPLORATORY LAPAROTOMY
Evacuation of intra-abdominal hematoma
Cautery of ovarian cyst rupture site
Findings: ~1400 ml of hemoperitoneum with right hemorrhagic cyst
Estimated Blood Loss:10 ml
Total IV Fluids: 1400 ml
Urine output: 400 ml
Specimens: N/A .
Complications: None; patient tolerated the procedure well.
The patient prepped and draped in dorsal supine position in normal sterile fashion. Foley catheter was inserted and bladder was emptied. Mini-laparotomy Pfannenstiel skin incision was made with the scalpel and incision was carried down to the fascia with bovie cautery. Fascia was incised and then extended. The superior portion part of the fascia was elevated and excised with Metzenbaum scissors. In a similar fashion, the inferior part of the fascia was elevated and the rectus muscle was dissected off with sharp dissection. Hemostasis was achieved with a Bovie. Preperitoneal fatty tissue was bluntly dissected to expose peritoneum. The peritoneum was entered and incision was extended superiorly and inferiorly. A significant amount of hemoperitoneum with clots was evacuated with pool suction and lap sponges measuring ~1400 mL. The right ovary was then elevated to the level of the incision and wrapped with a moist lap sponge. A small area of rupture of the ovarian capsule was noted, and appeared to be sealed. A bovie cautery was used to assure continued hemostasis; the cyst was about 1.2 cm in diameter so was not removed. Intra-operatively the patient received 2 units of PRBCs, and 1 unit of FFP. The blood clots and fluid were wiped out of the abdomen and pelvis with pool suction and moist laparotomy sponges. Lavage was carried out until clear. The muscle layer was closed. The fascial layer was closed in a running fashion. The skin was closed with suture in a subcuticular fashion. Instrument, sponge, and needle counts were correct prior the abdominal closure and at the conclusion of the case. The patient was taken to the recovery room in stable condition.
Thank you,
Cathy, CPC, COBGC
Procedure(s):
A7 EXPLORATORY LAPAROTOMY
Evacuation of intra-abdominal hematoma
Cautery of ovarian cyst rupture site
Findings: ~1400 ml of hemoperitoneum with right hemorrhagic cyst
Estimated Blood Loss:10 ml
Total IV Fluids: 1400 ml
Urine output: 400 ml
Specimens: N/A .
Complications: None; patient tolerated the procedure well.
The patient prepped and draped in dorsal supine position in normal sterile fashion. Foley catheter was inserted and bladder was emptied. Mini-laparotomy Pfannenstiel skin incision was made with the scalpel and incision was carried down to the fascia with bovie cautery. Fascia was incised and then extended. The superior portion part of the fascia was elevated and excised with Metzenbaum scissors. In a similar fashion, the inferior part of the fascia was elevated and the rectus muscle was dissected off with sharp dissection. Hemostasis was achieved with a Bovie. Preperitoneal fatty tissue was bluntly dissected to expose peritoneum. The peritoneum was entered and incision was extended superiorly and inferiorly. A significant amount of hemoperitoneum with clots was evacuated with pool suction and lap sponges measuring ~1400 mL. The right ovary was then elevated to the level of the incision and wrapped with a moist lap sponge. A small area of rupture of the ovarian capsule was noted, and appeared to be sealed. A bovie cautery was used to assure continued hemostasis; the cyst was about 1.2 cm in diameter so was not removed. Intra-operatively the patient received 2 units of PRBCs, and 1 unit of FFP. The blood clots and fluid were wiped out of the abdomen and pelvis with pool suction and moist laparotomy sponges. Lavage was carried out until clear. The muscle layer was closed. The fascial layer was closed in a running fashion. The skin was closed with suture in a subcuticular fashion. Instrument, sponge, and needle counts were correct prior the abdominal closure and at the conclusion of the case. The patient was taken to the recovery room in stable condition.
Thank you,
Cathy, CPC, COBGC
