Need help with coding. Any Advice? I had considered 33425, but thats not an exact match so now leaning more towards unlisted.
Operation: Removal of vegetation sitting in the left ventricular outflow tract.
Diagnosis: Endocarditis, recent transient ischemic
attack, history of rheumatic heart disease, mild-to-moderate mitral
stenosis, mild aortic insufficiency.
Here is an extraction from the report...
Median sternotomy was made using our standard techniques. The
pericardium was opened and reflected laterally. The patient was
anticoagulated. The ascending aorta was cannulated with a 20-French
aortic cannula. The right atrium was cannulated with a 46-French
2-stage venous cannula. Antegrade was placed in the ascending
aorta. A left ventricular vent was placed via the right superior
pulmonary vein. Cardiopulmonary bypass was instituted. The aorta
was crossclamped. A liter of cardioplegia was given antegrade. Ice
was used as a topical hypothermic agent. We did a transverse
aortotomy. We opened the mitral valve leaflets. There were some
excrescences on the aortic valve, which were also débrided. We
found the vegetation on the septum. It was excised in its entirety.
We looked at the rest of the mitral valve through this approach and
saw no evidence of any further disease. We then closed the
aortotomy with 3-0 Prolene using 2-layer closure technique. We then
resected the left atrial appendage and oversewed this with a 3-0
Prolene using 2-layer closure technique.
Operation: Removal of vegetation sitting in the left ventricular outflow tract.
Diagnosis: Endocarditis, recent transient ischemic
attack, history of rheumatic heart disease, mild-to-moderate mitral
stenosis, mild aortic insufficiency.
Here is an extraction from the report...
Median sternotomy was made using our standard techniques. The
pericardium was opened and reflected laterally. The patient was
anticoagulated. The ascending aorta was cannulated with a 20-French
aortic cannula. The right atrium was cannulated with a 46-French
2-stage venous cannula. Antegrade was placed in the ascending
aorta. A left ventricular vent was placed via the right superior
pulmonary vein. Cardiopulmonary bypass was instituted. The aorta
was crossclamped. A liter of cardioplegia was given antegrade. Ice
was used as a topical hypothermic agent. We did a transverse
aortotomy. We opened the mitral valve leaflets. There were some
excrescences on the aortic valve, which were also débrided. We
found the vegetation on the septum. It was excised in its entirety.
We looked at the rest of the mitral valve through this approach and
saw no evidence of any further disease. We then closed the
aortotomy with 3-0 Prolene using 2-layer closure technique. We then
resected the left atrial appendage and oversewed this with a 3-0
Prolene using 2-layer closure technique.