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Thread: Thoracotomy with excision of duplication cyst

  1. #1
    Join Date
    Apr 2007
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    Default Thoracotomy with excision of duplication cyst

    Does anyone know what code should be used for a Thoroactomy with excision of duplication cyst?

    Operative report states it was performed for a large cystic mass partially adherent to the esophageal wall with significan splaying of the esophagus.
    Transverse incision was made and a muscle-sparing thoracotomy was then performed mobilizing the lattismus posteriorly and the serratus anteriorly. The 3rd intercostal space was opened. The finochietto rib spreaders were then placed in opposing directions to facilitate access. Lung was retracted medially and esophagus was identified by the orogastric tube. Meticulous dissection was then carried out visualizing the esophagus, creating a dissection place from the cyst.....the cyst was then entered and a significant amount of mucoid and clear fluid was evacuated, this facilitated exposure. sequentially then the cyst was dissected....the mass was then dissected away from the esophagus. The thoracic inlet was reached, care taken to avoid injury to great vessels. ...Cyst was completedly exised and delivered from the field. Inspection of the esophagus showed no perforation. ....Lungs then reexpanded. Ribs closed, skin closed.

  2. #2
    Join Date
    Apr 2007
    Location
    Richardson, TX
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    817

    Default

    Quote Originally Posted by kimed34 View Post
    Does anyone know what code should be used for a Thoroactomy with excision of duplication cyst?

    Operative report states it was performed for a large cystic mass partially adherent to the esophageal wall with significan splaying of the esophagus.
    Transverse incision was made and a muscle-sparing thoracotomy was then performed mobilizing the lattismus posteriorly and the serratus anteriorly. The 3rd intercostal space was opened. The finochietto rib spreaders were then placed in opposing directions to facilitate access. Lung was retracted medially and esophagus was identified by the orogastric tube. Meticulous dissection was then carried out visualizing the esophagus, creating a dissection place from the cyst.....the cyst was then entered and a significant amount of mucoid and clear fluid was evacuated, this facilitated exposure. sequentially then the cyst was dissected....the mass was then dissected away from the esophagus. The thoracic inlet was reached, care taken to avoid injury to great vessels. ...Cyst was completedly exised and delivered from the field. Inspection of the esophagus showed no perforation. ....Lungs then reexpanded. Ribs closed, skin closed.

    What about 32140; thoracotomy with cyst(s) removal, with or without pleural procedure. That might fit pretty well...
    Julie Graham, BA, CPC, CCC

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