HELLO, CAN ANYONE HELP WITH CODING THIS? I AM NEW TO PULMONARY AND HEART.
CPT CODES: 32097,36561,32550,32557,31622,75989-26
PLEASE AND THANK YOU:
Procedure(s): Flexible bronchoscopy, right minimally invasive thoracotomy, decortication, pleural biopsy, mechanical and chemical pleurodesis, Pleurx catheter insertion, intercostal nerve blocks 2 through 8 on the right.
Anesthesia: General endotrachial anesthesia
Indications: See pre-operative history and physical.
Findings: Chronically trapped right lung with thickened pleura and recurrent effusion.
Specimen(s): Pleural fluid for cytology and culture. Empyema rind for pathology and culture. Pleura for pathology and culture.
Estimated Blood Loss: Less Than 100ml
Other: Implants: 32 French chest tubes. Pleurx catheter.
Complications: None.
Description of Procedure: After intubation a flexible bronchoscope was passed down the endotracheal tube. The airways were inspected from the trachea to the lobar bronchi bilaterally. There were no endobronchial lesions found. Patient was placed in the left lateral decubitus position and prepped and draped sterilely. A 3-1/2 inch vertical midaxillary minimally invasive thoracotomy incision was made over ribs 3 through 5. Electrocauterization was used to dissect down in between the leaves of serratus enter the fourth interspace. Large amount of recurrent pleural effusion that was amber-colored was found and evacuated. This was sent for cytology and culture. Retractors were placed. Lung was chronically trapped in the superior and mid aspect. There was chronic empyema that was decorticated. Empyema rind was sent for pathology and culture. Lung was decorticated as much as possible without causing damage. Pleura was noted to be thickened and pleural biopsy was performed sharply. The specimen was sent for pathology and culture. Right hemithorax was irrigated copiously with antibiotic irrigation. 2 stab incisions were made 32 French straight and right angle chest was replaced in the anterior apical and posterior lateral positions. These were secured with Ethibond suture. Stab incision was made in the right upper quadrant and in the right chest wall. PleurX catheter was tunneled from the right upper quadrant to the chest wall incision and then tunneled into the pleural space. This was secured to the skin with silk suture. Serratus was reapproximated in 1 Vicryl pericostal suture running fashion. Wound was irrigated vancomycin irrigation. Fashion deep tissue closed with 2 layers of #1 Vicryl suture. Skin was closed with a running 4-0 Monocryl suture. Intercostal nerve blocks 2 through 8 were performed on the right with 20 cc of quarter percent Marcaine without epinephrine. Patient was transported to the PACU in stable condition.
CPT CODES: 32097,36561,32550,32557,31622,75989-26
PLEASE AND THANK YOU:
Procedure(s): Flexible bronchoscopy, right minimally invasive thoracotomy, decortication, pleural biopsy, mechanical and chemical pleurodesis, Pleurx catheter insertion, intercostal nerve blocks 2 through 8 on the right.
Anesthesia: General endotrachial anesthesia
Indications: See pre-operative history and physical.
Findings: Chronically trapped right lung with thickened pleura and recurrent effusion.
Specimen(s): Pleural fluid for cytology and culture. Empyema rind for pathology and culture. Pleura for pathology and culture.
Estimated Blood Loss: Less Than 100ml
Other: Implants: 32 French chest tubes. Pleurx catheter.
Complications: None.
Description of Procedure: After intubation a flexible bronchoscope was passed down the endotracheal tube. The airways were inspected from the trachea to the lobar bronchi bilaterally. There were no endobronchial lesions found. Patient was placed in the left lateral decubitus position and prepped and draped sterilely. A 3-1/2 inch vertical midaxillary minimally invasive thoracotomy incision was made over ribs 3 through 5. Electrocauterization was used to dissect down in between the leaves of serratus enter the fourth interspace. Large amount of recurrent pleural effusion that was amber-colored was found and evacuated. This was sent for cytology and culture. Retractors were placed. Lung was chronically trapped in the superior and mid aspect. There was chronic empyema that was decorticated. Empyema rind was sent for pathology and culture. Lung was decorticated as much as possible without causing damage. Pleura was noted to be thickened and pleural biopsy was performed sharply. The specimen was sent for pathology and culture. Right hemithorax was irrigated copiously with antibiotic irrigation. 2 stab incisions were made 32 French straight and right angle chest was replaced in the anterior apical and posterior lateral positions. These were secured with Ethibond suture. Stab incision was made in the right upper quadrant and in the right chest wall. PleurX catheter was tunneled from the right upper quadrant to the chest wall incision and then tunneled into the pleural space. This was secured to the skin with silk suture. Serratus was reapproximated in 1 Vicryl pericostal suture running fashion. Wound was irrigated vancomycin irrigation. Fashion deep tissue closed with 2 layers of #1 Vicryl suture. Skin was closed with a running 4-0 Monocryl suture. Intercostal nerve blocks 2 through 8 were performed on the right with 20 cc of quarter percent Marcaine without epinephrine. Patient was transported to the PACU in stable condition.