bhargavi
Guru
Cardiac BIV ICD Pocket hematoma evacuation and exploration Operative Report
Procedure(s): BIV ICD Pocket Hematoma Evaluation and Exploration
Indications:
BIV ICD Pocket Hematoma
NonIschemic Dilated Cardiomyopathy; Primary prevention
Chronic systolic CHF FC II
LBBB
Tachy brady syndrome
Hardware Implanted:
## MRI COMPATIBLE SYSTEM ##
None
Hardware Explanted:
None
Procedure Details
The risks, benefits, complications, treatment options, and expected outcomes were discussed with the patient. The patient and/or family concurred with the proposed plan, giving informed consent. Patient was marked and timeout done.
The antibiotic was completely infused. The patient was prepped and draped in the usual sterile fashion and the left upper chest anesthetized with 10 cc of 50/50 mixture of 0.25% marcaine and 2% lidocaine. An incision was made in the deltopectoral groove and electrocautery used to perform dissection down to the device pocket where the pocket was incised. The prepectoralis hematoma was evacuated and was small. The subpectoral device pocket was explored, and the large pocket hematoma was evacuated and evacuated and pocket irrigated indicating no active oozing. The device was not required to be delivered from the pocket. Irrigation returned clear pocket irrigation. The pectoralis was reapproximated with interrupted 0-ethibond. The prepectoralis space was irrigated with hemostasis.
The incision was closed in 3 layers, the lower two with running 2-0 Vicryl and the cutaneous with 4-0 Vicryl. Steri-Strips and a dry sterile dressing were placed over the wound and the patient was transferred to the PACU in stable condition for recovery from anesthesia.
Device was pacing normally throughout. No reprogramming, remains as previously programmed.
thanks in advance
can i bill 33233? but he didnot relocate pocket
Procedure(s): BIV ICD Pocket Hematoma Evaluation and Exploration
Indications:
BIV ICD Pocket Hematoma
NonIschemic Dilated Cardiomyopathy; Primary prevention
Chronic systolic CHF FC II
LBBB
Tachy brady syndrome
Hardware Implanted:
## MRI COMPATIBLE SYSTEM ##
None
Hardware Explanted:
None
Procedure Details
The risks, benefits, complications, treatment options, and expected outcomes were discussed with the patient. The patient and/or family concurred with the proposed plan, giving informed consent. Patient was marked and timeout done.
The antibiotic was completely infused. The patient was prepped and draped in the usual sterile fashion and the left upper chest anesthetized with 10 cc of 50/50 mixture of 0.25% marcaine and 2% lidocaine. An incision was made in the deltopectoral groove and electrocautery used to perform dissection down to the device pocket where the pocket was incised. The prepectoralis hematoma was evacuated and was small. The subpectoral device pocket was explored, and the large pocket hematoma was evacuated and evacuated and pocket irrigated indicating no active oozing. The device was not required to be delivered from the pocket. Irrigation returned clear pocket irrigation. The pectoralis was reapproximated with interrupted 0-ethibond. The prepectoralis space was irrigated with hemostasis.
The incision was closed in 3 layers, the lower two with running 2-0 Vicryl and the cutaneous with 4-0 Vicryl. Steri-Strips and a dry sterile dressing were placed over the wound and the patient was transferred to the PACU in stable condition for recovery from anesthesia.
Device was pacing normally throughout. No reprogramming, remains as previously programmed.
thanks in advance
can i bill 33233? but he didnot relocate pocket