hchitwood0002
New
I am so confused on how to code this. I know my debridement code but i dont know what to use for the Venous BX????? Please if anyone can shed ligh ton this I would be so grateful.
Procedure: Excisional Biopsy of Venous segements from probable basilic vein, right upper extremity. Debridment of RT upper extremity distal wound.
Detail: Once the aptient was satisfactorily anesthetized, his arms were outstratched on are board and circumferentally prepped and draped in usual fashion. Attention was directed to right upper extremity where the nodular area in the medial right antecubital fossa was identified. A transverse skin incision was created over the line of dissection through the sub tissues and performed with a 15-blade scapel. The inflammatory process was noted to be fairly superficial and above the level of the fascia, Certainly, above the level of the brachail artery. However, on further dissection around the area that appeared to be abscesed, this appeared to be a inflammation of the vessel. This was dissected out, clamped proximally and disally, and approximately 1 cm section of vessel with surrounding inflammation was removed with a 15-blade. Proximally and distally was then tied with a 2-0 Vicryl in figure-of-eight fashion individually. Prior to complete ligation, we confirm that this was not arterial supply by releasing clamps and no arterial pulsatile bleeding was identified. With the vessel controlled proximally and distally, the wound was made hemostatic otherwise from the wound, and then closed with a 3-0 nylon in multiple interrupted fashion. Next, attention directed at the superficial ulcerated wound on the right upper extremity where the patient had attemped his own debridement, a curettage was then performed with a spoon style curette through the necrotic skin and sub tissue. No deep tissue levels were encountered. once the wound was sufficiently curette the wound was the irrigated and dressed .
Procedure: Excisional Biopsy of Venous segements from probable basilic vein, right upper extremity. Debridment of RT upper extremity distal wound.
Detail: Once the aptient was satisfactorily anesthetized, his arms were outstratched on are board and circumferentally prepped and draped in usual fashion. Attention was directed to right upper extremity where the nodular area in the medial right antecubital fossa was identified. A transverse skin incision was created over the line of dissection through the sub tissues and performed with a 15-blade scapel. The inflammatory process was noted to be fairly superficial and above the level of the fascia, Certainly, above the level of the brachail artery. However, on further dissection around the area that appeared to be abscesed, this appeared to be a inflammation of the vessel. This was dissected out, clamped proximally and disally, and approximately 1 cm section of vessel with surrounding inflammation was removed with a 15-blade. Proximally and distally was then tied with a 2-0 Vicryl in figure-of-eight fashion individually. Prior to complete ligation, we confirm that this was not arterial supply by releasing clamps and no arterial pulsatile bleeding was identified. With the vessel controlled proximally and distally, the wound was made hemostatic otherwise from the wound, and then closed with a 3-0 nylon in multiple interrupted fashion. Next, attention directed at the superficial ulcerated wound on the right upper extremity where the patient had attemped his own debridement, a curettage was then performed with a spoon style curette through the necrotic skin and sub tissue. No deep tissue levels were encountered. once the wound was sufficiently curette the wound was the irrigated and dressed .
