Coastal Coder
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I have pasted the note below for any help with coding for this procedure. I am correct in using these codes? 23071, 12032, 38510, 38900? Thanks for the help\DESCRIPTION OF PROCEDURE: Before the procedure the patient was sedated under general anesthesia, placed in a left lateral decubitus position. Methylene blue dye was injected in the dermis at the lesion. At this time the surgical area was prepped with Betadine. After appropriate time had elapsed sterile drapes were applied. The lesion was measured as 1 x 2 cm in size. A margin of 1 cm was marked around the lesion and then a 15 x 5 cm elliptical incision was made using a #15 blade. The incision was made transversely over the posterior portion of the shoulder in the skin lines. Using electrocautery the epidermis, dermis, and subcutaneous fat were completely removed all the way down to the overlying fascia of the shoulder musculature. Once the specimen was taken out it was marked and sent to pathology. Subcutaneous flaps were created along the muscular fascia anteriorly and posteriorly to free the tissues and allow closure of the wound. The wound was then closed in 3 layers total, the first being subcutaneous tissue with 3-0 Vicryl interrupted stitches. The skin was then closed with 3-0 Ethilon interrupted vertical mattresses sutures. A 3 cm incision was then made over the previous marked area where the single lymph node was identified on lymphoscintigraphy in the left posterior cervical triangle. Using electrocautery and blunt dissection we were able to locate the node with our Geiger counter and by identifying the blue dye in the lymphatic vessels. The lymph node was excised with ligation of the lymphatic vessels supplying it. The area was then closed with a running 4-0 Monocryl. A sterile dressing was placed on both incision sites. The patient tolerated the procedure without difficulty. At the end of the case the patient was extubated and sent to the PACU in excellent condition.