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Wiki Post op mediastinal re-exploration for bleeding

kwrenn

Guru
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Location
London, OH
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HI! Would anyone know what CPT code to use for a same day return to the OR for a mediastinal bleed? I code for anesthesia.

Patient who underwent urgent coronary bypass
surgery earlier today. He had been loaded with Plavix the day before.
Initially, he returned to open-heart recovery and had an uneventful
postop course but began bleeding from his mediastinal chest tube. He
was given fresh frozen plasma and platelets but bleeding persisted. He
was returned to surgery for re-exploration. Indications, risks and
benefits were discussed.

"The sternum was reopened uneventfully. There was a moderate amount
mediastinal hemorrhage identified. The bleeding source was a bleeding
arterial vessel on the upper chest wall in the vicinity of the mammary
takedown. The vessel was cauterized and bleeding ceased. No additional
sources of bleeding were identified. The sternum was reclosed with
stainless steel wires. Subcutaneous tissue and skin edges approximated
with Vicryl. The patient was transferred back to the recovery room in
satisfactory condition."

I was thinking 39000 though doesn't mention hemorrhage!?! Or 35820, but more for the chest and not the mediastinum. Any suggestions? TIA:)
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My guess is it will be 00540 - Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified[FONT=&quot]
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