VP Shunt occlusion

jd27

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Need help coding the following report (details below). We're thinking of using 62230 w/52 modifier or an unlisted (64999). Can't find anything better than 62230 and we'd like to avoid using an unlisted code. Thanks for any assistance.

POSTOPERATIVE DIAGNOSIS
Bilateral subdural hygromas secondary to over shunting of ventriculoperitoneal shunt.

OPERATION
Occlusion of ventriculoperitoneal catheter, right anterior thoracic area.

Patient had a subarachnoid hemorrhage from a ruptured aneurysm. Developed hydrocephalus and a ventriculoperitoneal shunt was placed. Recently, a CT scan showed a significant volume of bilateral subdural hygromas, which had increased in the interval over the past 2 months. Occlusion of the shunt is recommended.

PROCEDURE
The patient underwent IV sedation. Anterior thoracic area was prepped and draped in a standard fashion. A small transverse incision was made just below the clavicle on the right side over the shunt tubing. Two vascular clamps were placed on the catheter to occlude it. Closure of the subcutaneous was with 3-0 Vicryl, the skin was closed with 5-0 Monocryl in a subcuticular fashion. Sterile dressing was applied. There were no complications.
 

jd27

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Good question which unfortunately I don't know the answer to. I do know that the shunt was placed awhile back (and not by our doctors). I'm assuming there either was no valve or possibly it was malfunctioning, but there is no mention of it in his report.

Thanks!
 
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