Wiki Subcutaneous emphysema s/p VATS

[Pam Warren]

Hi, need someone else to take a look and see if there's a better solution to my coding question. This patient has a subcutaneous emphysema, s/p a VATS done 5 days prior. The surgeon performed a 1 cm incision on the anterior chest wall, inserted a blake drain and expressed the air. I'm inclined to bill a 17999-78, but if anyone knows what STS recommends, I'd be grateful. The emphysema is definitely subcutaneous.....so a 32551 is inappropriate. Thoughts?
Thanks, Pam

 

[jewlz0879]

I would not use 17999-78. Did he leave the chest tube in for continous or intermittent removal or air or fluid? I would bill 32551-78 as this is used to drain hemothorax or empyema.

HTH

 

[Torilinne]

32551 involves incision down into the pleura which doesn't seem to fit for subcutaneous emphysema. I've looked and looked but can't seem to find anything better than your unlisted code but this is expression of air, not fluid of any kind. There just doesn't seem to be a better option and I know it's going to be a pain to try to get any payment out of it.....good luck!

Torilinne
CPC CGIC

 

[Pam Warren]

This isn't for hemothorax....the air is subcutaneous; I can't support the 32551 with the diagnosis, even though the 17999 will be difficult to get paid.

I agree, Torilinne, I'll have trouble getting this one paid, but I'll send notes!