I wasn't sure which forum to post this too. I've asked the AAPC to create a Pulmonary forum but has never been done.
Can anyone help with the below? My thought
31629, 31623-51 and 31624-51
A standard bronchoscope was inserted through the LMA and advanced to the carina which was sharp and midline. The left mainstem bronchus was entered. There appeared to be a fleshy soft tissue redundancy entering the entrance to the left lower lobe at the 2-o'clock position. As this did not enhance on PET imaging, I elected not to biopsy this. The superior subsegment and the remainder of the left lower lobe subsegments were inspected. All ostia were patent subcarina were sharp. The bronchoscope was withdrawn, and the right lung was entered. The right upper lobe was patent, and all sharp. Upon advancing to the bronchus intermedius, the right lower lobe was entered which appeared normal. The right middle lobe was abnormal. The entrance to the lateral subsegment was obscured, and there did appear to be a an abnormal thickened area along the lateral subsegment of the right middle lobe at the 3-o'clock position. A wang needle biopsy was inserted into this area, and on preliminary pathology on 1st attempt, malignant cells were identified, favoring squamous cell carcinoma. Additional biopsies were obtained from this region. Brushings was obtained from this region and finally a 30 mL bronchoalveolar lavage into the left subsegment of the right middle lobe was performed with approximately 15 mL return. The bronchoscope was removed.
Can anyone help with the below? My thought
31629, 31623-51 and 31624-51
A standard bronchoscope was inserted through the LMA and advanced to the carina which was sharp and midline. The left mainstem bronchus was entered. There appeared to be a fleshy soft tissue redundancy entering the entrance to the left lower lobe at the 2-o'clock position. As this did not enhance on PET imaging, I elected not to biopsy this. The superior subsegment and the remainder of the left lower lobe subsegments were inspected. All ostia were patent subcarina were sharp. The bronchoscope was withdrawn, and the right lung was entered. The right upper lobe was patent, and all sharp. Upon advancing to the bronchus intermedius, the right lower lobe was entered which appeared normal. The right middle lobe was abnormal. The entrance to the lateral subsegment was obscured, and there did appear to be a an abnormal thickened area along the lateral subsegment of the right middle lobe at the 3-o'clock position. A wang needle biopsy was inserted into this area, and on preliminary pathology on 1st attempt, malignant cells were identified, favoring squamous cell carcinoma. Additional biopsies were obtained from this region. Brushings was obtained from this region and finally a 30 mL bronchoalveolar lavage into the left subsegment of the right middle lobe was performed with approximately 15 mL return. The bronchoscope was removed.