sclerosis of seroma

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Greater Portland (Maine)
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I'd been using 17999 for alcohol ablation of a seroma, but recently came across some guidance to use 20500 instead. Any opinions? Here's a sample case.

INDICATION: BACK SEROMA

FINDINGS: The risks were explained and informed consent was obtained. Ultrasound was performed and it showed no residual fluid collection. The end of the existing drain over the left latissimi dorsi flap was injected with 10 milliliters of 1% lidocaine, 15 milliliters of absolute alcohol was then instilled and allowed to dwell for 15 minutes. It was removed. The process was repeated with additional 15 milliliters of alcohol. This was then removed. 5-milliliters of 0.25% bupivacaine were then placed in the space and allowed to dwell. The patient was discharged uneventfully. Follow-up care plan has been given. We place to see the patient back in one week or sooner if drainage stops.
 

donnajrichmond

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Alexandria, LA
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The 20500 advice stems from an example in the 2011 SIR guide. The question was concerning drain placement into a pelvic lymphocele and subsequent alcohol sclerosis. SIR said to code 20500 for the alcohol sclerosis.
That would fit here as well, though I don't think the unlisted code is absolutely wrong.
 
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