Results 1 to 2 of 2

Release of vestibular stenosis bilaterally

  1. #1
    Default Release of vestibular stenosis bilaterally
    Medical Coding Books
    Stuck on this one . Patient had a release of vestibular stenosis bilaterally with local tissue rearrangement and a full thickness skin graft and removal of hardware. The dx was vestibular stenosis with impaired airway, status post total nasal reconstruction with radial forearm flap because of extensive squamous cell carcinoma . I looking at

    here is op report

    An incision was made across the base of the columella and across the edge of the nares where the forehead flap ha been sewn to the ling and the forehead flap was elevared up to the level of the tip .
    This allowed acess to the anterior portion of the nose. There was a scar babd on the right, which was obstructing the airway and also some boggy tissue from the superior aspect of the narrow airway was collasping down to the airway. This was underminded bebneath the cartilage structure. There eas good bit of fat, which was retained in the area and the flap was then defatted.
    Once the flap has been satisfactorily defatted, there was still narrowing of stenosis superirly and a full thickness skin graft was harvested from the right lateral brow area and pkaced into this deficiency. It was sewn in with the 5-0 Vicryl sutures. A single PDS suture was then used transmurally to fixate the skin back up to the lateral wall once the fat had been removed and 2 additional sutures were used. This seem TOopen up upper part of airway quite nicely and a Z -plasty was performed on the web in front portion of the nose and repaired with 5-0 sutures.
    There was also a budle in the columella on the right side, which was a hardware, which was no longer needed and there was a long plarte, which was removed and a smaller olate, which was removed to the point where it was set into the area of the anterior nasal spine and would have b een in the mouth, so that left a small portion of the plate was left intact. The opposite site was then identifid and it was explored. Here there was a piece of projecting cartilage in the airway from thec old cartilage freamework, it was trimmed back. The lining flap on both sides was then cut back for about 4mm in order to allow for better movement of linning up into the apex of the nostril. The wounds were then closed w ith 5-0 Vicryl AND 2 stents were placed in nose.

    Please help if can , so far I AM LOOKING AT 14060/ I KNOW THERE IS MORE , ANY SUGGESTIONS ?

  2. #2

    NOT my specialty but look at CPT code 30465.

    Julie, CPC

Similar Threads

  1. Spinal stenosis vs foraminal stenosis
    By amandamcelrath in forum ICD-10
    Replies: 0
    Last Post: 10-08-2015, 07:39 AM
  2. 22630 bilaterally
    By mcsazei in forum Orthopaedics
    Replies: 2
    Last Post: 06-01-2012, 08:50 AM
  3. Help with procedure code for nasal vestibular stenosis
    By GRANNAN in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 04-06-2012, 12:08 PM
  4. Diagnosis code for vestibular stenosis
    By ulmer in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 05-24-2011, 11:23 PM
  5. Foraminal Stenosis vs Thecal Sac Stenosis
    By heiditipherwell in forum Diagnosis Coding
    Replies: 1
    Last Post: 08-12-2009, 08:49 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.