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11642,1460, 21235 ?

  1. #1
    Default 11642,1460, 21235 ?
    Medical Coding Books
    would cpt codes 11642, 14060, 21235 be the right codes ?
    also looking at dx code 171.0

    PREOPERATIVE DIAGNOSIS: Basal cell carcinoma of the posterior surface of the right ear involving the cartilage.

    POSTOPERATIVE DIAGNOSIS: Basal cell carcinoma of the posterior surface of the right ear involving the cartilage.

    OPERATION: 1. Excision of basal cell carcinoma, 2.0 x 2.0 cm, with the underlying scapha-cartilage. 2. Reconstruction with conchal cartilage graft and postauricular flap (local tissue rearrangement).
    thanks trent

    The patient was taken to the operating room, with a noted lesion on the posterior surface of the right ear. After being prepped and draped, the posterior ear was infiltrated with 1% Xylocaine with adrenaline 1:100,000. The lesion had been marked with a 5 mm margin. Incision was carried down through the skin and subcutaneous tissue and the skin was removed off of the posterior surface of the perichondrium. It was submitted to the lab and the peripheral margins were said to be clear, but the tumor was in the perichondrium. The underlying cartilage was then excised including the superior crus of the antihelix and submitted to permanent section.

    Because of the lack of the posterior crus, a cartilage graft was planned using a template and an anterior incision was made in the conchal cavity, and the skin was elevated. A graft which matched the form of the posterior crus was then harvested. The donor site was closed with 5-0 chromic and a transfixion suture of 5-0 chromic. The graft was then carved and then placed in the position on the ear and sewn in position with 5-0 Vicryl.

    A postauricular flap was then elevated 2 cm x 4 cm and the flap was rotated in the position to cover the exposed cartilage graft. The donor site was closed directly by advancing the mastoid skin to the periosteum of the mastoid and then the flap was repaired with 4-0 Vicryl. A mastoid dressing was then applied.

    The patient tolerated the procedure well and was sent back to the recovery room in good condition.

    _____________________________________ ______________
    Last edited by codedog; 12-19-2010 at 08:51 PM.

  2. Default
    On going through your OP notes, your code sets seem to be perfect.
    yes, theCode for graft of the cartilage includes obtaining the graft too.
    Well done!

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