shobaram
Contributor
Hi,
Treating For Hydrocephalus, possible VP shunt malfunction, and external cerebral fluid collection,
Procedure performed: Revision of proximal ventriculoperitoneal shunt placement of new ventriculoperitoneal shunt catheter with computer navigation,directed to the left frontal horn spanning the septum pellucidum; testing of distal valve and reservoir and adjustment of shunt valve down to 10 cam of water.
The pt was placed in supine position and the previously made incision was incised. previously placed sutures underneath the subcuticular layer were removed. The shunt was identified. The Ventricular catheter was then detached from the proximal aspect of the control reservoir. Reasonable cerebrospinal fluid return was noted from the proximal ventricular catheter. This control reservoir was then attached to a tube and distal runoff to the setting to the valve, which was approximately 16. At that point the ventricular catheter was then removed and a new ventricular catheter was passed down to a new target set at the left frontal horn. A good cerebrospinal fluid return was then noted. This pathway was intended to span the septum as well as have some entry into the right frontal horn as well, thus drainging both ventricular systems. This was cut to the appropriate size and attached to the proximal portion of the control valve. This was secured in place with 2-0 silk tie. The fluid was extremely clear and was not consistent with an infection whatsoever. The silk tie was applied to the attachment. The reservoir was then pressed several times to ensure that it refilled quickly, which it did. The tissue especially the galea was somewhat decayed from the previous surgery. A series of full thickness prolene and PDS non-braided sutures were required in order to approximate the edges. A single screw was used to fix the connector to the burr hole and burr hole cover was used also prior to closure to cover the burr hole. The wound was covered and the pt was taken back to the unit for recovery.
Is the correct coding 62230 & 62225, would like to know what is the cpt to be used for computer navigation (61781) or is it part of the procedure???
Thanks in advance,
SS
Treating For Hydrocephalus, possible VP shunt malfunction, and external cerebral fluid collection,
Procedure performed: Revision of proximal ventriculoperitoneal shunt placement of new ventriculoperitoneal shunt catheter with computer navigation,directed to the left frontal horn spanning the septum pellucidum; testing of distal valve and reservoir and adjustment of shunt valve down to 10 cam of water.
The pt was placed in supine position and the previously made incision was incised. previously placed sutures underneath the subcuticular layer were removed. The shunt was identified. The Ventricular catheter was then detached from the proximal aspect of the control reservoir. Reasonable cerebrospinal fluid return was noted from the proximal ventricular catheter. This control reservoir was then attached to a tube and distal runoff to the setting to the valve, which was approximately 16. At that point the ventricular catheter was then removed and a new ventricular catheter was passed down to a new target set at the left frontal horn. A good cerebrospinal fluid return was then noted. This pathway was intended to span the septum as well as have some entry into the right frontal horn as well, thus drainging both ventricular systems. This was cut to the appropriate size and attached to the proximal portion of the control valve. This was secured in place with 2-0 silk tie. The fluid was extremely clear and was not consistent with an infection whatsoever. The silk tie was applied to the attachment. The reservoir was then pressed several times to ensure that it refilled quickly, which it did. The tissue especially the galea was somewhat decayed from the previous surgery. A series of full thickness prolene and PDS non-braided sutures were required in order to approximate the edges. A single screw was used to fix the connector to the burr hole and burr hole cover was used also prior to closure to cover the burr hole. The wound was covered and the pt was taken back to the unit for recovery.
Is the correct coding 62230 & 62225, would like to know what is the cpt to be used for computer navigation (61781) or is it part of the procedure???
Thanks in advance,
SS