DLT
Guest
- Messages
- 28
- Location
- Reading, PA
I am new to coding plastic surgery and I want to make sure I am not missing anything when coding the following report:
15260 - nose graft
13152 (bundled)
11042 (bundled)
15732 - nasal flap
Left retroauricular full thickness graft harvested measuring 5x3cm. The 5x3cm skin graft donor site defect was closed primarily in multiple layers with 3.0 vicryl and 4.0 nylon after hemostasis was achieved and extensive undermining was performed at the level of the periosteum to allow for a primary closure. The nose was then sharply debrided of devitalized tissues and fresh edges were achieved where healthy bleeding was seen in what was initially a necrotic, dry region. The wound was copiously irrigated with dilute betadine and hemostasis achieved. Nasal skin flaps were created and the flaps were mobilized for 0.5cm in all directions just above the nasalis muscle and the sharp angles were closed primarily with 5.0 vicryl and 5.0 nylon, encompassing 3cm in closure so that the remaining defect was 1.8x1.7x0.6cm. The skin graft was sharply thinned of all fatty tissue to deep dermis, pie crusted, and placed in the wound so as to fall to the base and sit with no tension or elevation from the base of the wound. It was secured with 5.0 chromic and trimmed of excess tissue. 4.0 silk bolster sutures were placed and the wound was packed with a layer of xeroform then bacitracin soaked gauze and the tied over bolster was secured. The wounds were cleaned and dressed with bacitracin and gauze.
Any advise would be helpful.
Thank you
Dana
15260 - nose graft
13152 (bundled)
11042 (bundled)
15732 - nasal flap
Left retroauricular full thickness graft harvested measuring 5x3cm. The 5x3cm skin graft donor site defect was closed primarily in multiple layers with 3.0 vicryl and 4.0 nylon after hemostasis was achieved and extensive undermining was performed at the level of the periosteum to allow for a primary closure. The nose was then sharply debrided of devitalized tissues and fresh edges were achieved where healthy bleeding was seen in what was initially a necrotic, dry region. The wound was copiously irrigated with dilute betadine and hemostasis achieved. Nasal skin flaps were created and the flaps were mobilized for 0.5cm in all directions just above the nasalis muscle and the sharp angles were closed primarily with 5.0 vicryl and 5.0 nylon, encompassing 3cm in closure so that the remaining defect was 1.8x1.7x0.6cm. The skin graft was sharply thinned of all fatty tissue to deep dermis, pie crusted, and placed in the wound so as to fall to the base and sit with no tension or elevation from the base of the wound. It was secured with 5.0 chromic and trimmed of excess tissue. 4.0 silk bolster sutures were placed and the wound was packed with a layer of xeroform then bacitracin soaked gauze and the tied over bolster was secured. The wounds were cleaned and dressed with bacitracin and gauze.
Any advise would be helpful.
Thank you
Dana