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Thread: Removal chest wall nodule- ribs not incl

  1. #1

    Default Removal chest wall nodule- ribs not incl

    AAPC: Back to School
    SO I was in the 19271 area and they all include ribs.. ANy coding help

    Left chest wall subcutaneous nodules, nodular pleural thickening of left
    chest, rule out mesothelioma versus other carcinoma.
    Poorly differentiated carcinoma.
    Excision of left chest wall nodule.
    The patient was brought to the operating room and placed supine on the
    operating table. The procedure was done with conscious sedation and
    local analgesia. The patient was positioned supine on the operating
    table. His left arm was abducted at the shoulder on an arm board. His
    left axilla and chest wall were prepped and draped in the usual sterile
    fashion. The patient had a mobile palpable subcutaneous nodule overlying
    the fourth intercostal space in the mid axillary line. Prior to making a
    skin incision with a 15-blade, 7 mL of 0.5% MARCAINE without EPINEPHRINE
    were instilled into the subcutaneous tissues and the tissues surrounding
    the nodule. A skin incision was made and electrocautery was used to
    dissect down through subcutaneous tissues. Blunt dissection was used to
    help mobilize the nodule from surrounding tissues. A small lymph versus
    small vascular structure was tied off with Vicryl ties. The nodule was
    excised and sent for frozen section analysis. After achieving complete
    hemostasis, 2-0 Vicryl was used in an interrupted inverted fashion to
    reapproximate the Scarpas fascia. A 4-0 Monocryl was used to close the
    skin. Mastisol and Steri-Strips were applied, followed by dry sterile
    dressing. The frozen section analysis revealed poorly differentiated

  2. #2
    Join Date
    Apr 2007
    Johnson City


    Code 21555 or 21552, depending on the size should do the trick.
    Melissa Jewett, CPC

  3. #3


    PERFECT.. wonderful. Thank you so much Melissa

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