vkratzer
Guru
Pt had an adenoma of the nipple removed and then surgeon reconstructed the nipple. See op report.
POSTOPERATIVE DIAGNOSIS: LEFT NIPPLE ADENOMA
OPERATION: EXCISION OF LEFT NIPPLE ADENOMA WITH
RECONSTRUCTION OF THE LEFT NIPPLE
OPERATIVE FINDINGS: All of the involved tissue in the interdermal plane of the left nipple was removed preserving some of the skin of the nipple for reconstruction. The reconstruction proceeded without difficulty.
OPERATIVE PROCEDURE: With the patient in the supine position after being appropriately identified on the Operating Room table IV sedation was achieved. The left breast was then prepped and draped in the usual sterile fashion. I made my wedge excision of some of the skin of the nipple directed laterally and at the 3 o'clock position and outlined this down to the junction of the nipple with the areola and then a V shaped incision carried out across to the mid point of the areola to allow reconstruction of the base of the nipple. This V was then incised and then the wedge incision removing a wedge of skin and all the subdermal tissue of the nipple was made and the dissection of the adenoma out of the nipple was carried out. Bleeding was controlled with electrocautery and I then reconstructed the nipple bringing the corners of the base of the nipple together which brought the V and the areola together. I then ran this stitch out to the apex of the areolar incision. I then ran another stitch up to the base of the V that was in the top of the nipple. I then ran a third stitch from this over to the central aspect of the nipple. This effectively reconstructed the nipple. A sterile dressing was applied. She tolerated the procedure well and was in good condition at the conclusion.
19120 - exc adenoma
Not sure if I can code anything else for reconstruction. Any suggestions?
Vicky
POSTOPERATIVE DIAGNOSIS: LEFT NIPPLE ADENOMA
OPERATION: EXCISION OF LEFT NIPPLE ADENOMA WITH
RECONSTRUCTION OF THE LEFT NIPPLE
OPERATIVE FINDINGS: All of the involved tissue in the interdermal plane of the left nipple was removed preserving some of the skin of the nipple for reconstruction. The reconstruction proceeded without difficulty.
OPERATIVE PROCEDURE: With the patient in the supine position after being appropriately identified on the Operating Room table IV sedation was achieved. The left breast was then prepped and draped in the usual sterile fashion. I made my wedge excision of some of the skin of the nipple directed laterally and at the 3 o'clock position and outlined this down to the junction of the nipple with the areola and then a V shaped incision carried out across to the mid point of the areola to allow reconstruction of the base of the nipple. This V was then incised and then the wedge incision removing a wedge of skin and all the subdermal tissue of the nipple was made and the dissection of the adenoma out of the nipple was carried out. Bleeding was controlled with electrocautery and I then reconstructed the nipple bringing the corners of the base of the nipple together which brought the V and the areola together. I then ran this stitch out to the apex of the areolar incision. I then ran another stitch up to the base of the V that was in the top of the nipple. I then ran a third stitch from this over to the central aspect of the nipple. This effectively reconstructed the nipple. A sterile dressing was applied. She tolerated the procedure well and was in good condition at the conclusion.
19120 - exc adenoma
Not sure if I can code anything else for reconstruction. Any suggestions?
Vicky