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Thread: Correct cpt for a limited thoracotomy w/ evacuation of hemathorax

  1. #1

    Default Correct cpt for a limited thoracotomy w/ evacuation of hemathorax

    AAPC: Back to School
    I'm having trouble finding the correct cpt code that I should use for surgery that was performed by one of our surgeons. He did a thoracoscopy and limited thoracotomy w/ evacation of hemothorax and also removed a portion of the patients rib. Any suggestions??? Thanks

  2. #2

    Default Hi

    I think we can take 32150. But not sure

  3. #3

    Default thoracotomy see attached op note. what would the code/codes be?

    1. Left thoracotomy
    2. Repair of paraesophageal hernia
    3. Belsey Mark V fundoplication

    PROCEDURE: After having obtained informed consent, the patient was taken to the
    operating room and placed on the operating room table in the supine position. After
    placement of appropriate monitoring lines, general endotracheal anesthesia was
    induced and a double lumen endotracheal tube was placed. Appropriate time-out was
    taken and the patient was turned in the full right lateral decubitus position. The
    left chest was then prepped and draped in the usual sterile fashion. A limited
    partial muscle sparing left thoracotomy was performed through the sixth intercostal
    space. On exploration the hernia was noted medially and inferiorly and the inferior
    pulmonary ligament was divided. The esophagus was dissected up above the area of
    the hernia and surrounded with a Penrose drain. Dissection was then carried down
    inferiorly up towards the pulmonary vessels and then inferiorly down to the hernia.
    The hernia sac was fully dissected free from the pericardium diaphragm and was
    partially removed. The crural edges were identified and dissected free for repair
    of the hernia. Diaphragm was dissected free anteriorly. At this point then the
    gastroesophageal junction was identified and the fat pad was fully dissected off of
    this area. Next, crural stitches were placed posterior of #0 silk. These stitches
    were interrupted figure-of-eight sutures but remained untied to finish the
    fundoplication. At this point then the Belsey Mark IV fundoplication was done again
    with 0 silk using two rows and a 240 degree wrap. The final row of stitches was
    through the diaphragm and these were snugged down but not tied at this point. The
    crural stitches were then sequentially tied down to finger-tip tightness around the
    esophagus with an orogastric tube in place. Once this was achieved the
    fundoplication stitches were tied with good reduction down below the diaphragm. No
    obvious gaps in the closure. The chest cavity was then copiously irrigated with
    normal saline. Blood loss was approximately 300 mL. An On-Q Marcaine pump was
    placed posteriorly in the subpleural space and a single 24 French chest tube for
    drainage. Chest was then closed in the usual fashion with Mersilene intercostal
    sutures, PDS muscle and fascial closure and skin staples. Patient tolerated the
    procedure well. She was extubated and taken to the PACU in satisfactory and stable

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