confusedThis dr's perform two surgeries on different dates and I have no clue how to code it out need diagnosis along with the cpt code:
1st SX's
This patient was to undergo a lead placement for chronic pain syndrome per Neurosurgery. Therefore, a preauricular incision was made following the crease already present in front of the treachea in and around the ear lobe, and then to the back in the retroauricular position and straight back into the hairline. Mobilization was done in the superificial plane just beneath hair follicles and above this smas layer, this was done in the preauricular position as well as lateral neck and posterior scalp. Care was taken not to injure greater occipital or spinal accessory or external jugular veins in the A pocket was made superior to the incision in the posterior scalp, this was jusb above in a galeal plane. The patient has lead placement by Neurosurgery. It is noted there was no undue tension since no skin had been removed to the face-lift incision and the leads do not appear to exert undo pressure on the flap itself.

2nd SX's
The previous face-lift incision was re-accessed by removing all sutures. The fascial flaps were elevated. A small amount of seromas was suctioned out and the leads were then reorganized and reoriented by Neurosurgery. Upon completion of Neurosurgery procedure, the pocket was closed inverted interrupted 3-0 Monocryl and a running subcuticular 4-0 Monocry and the fascial incisions were closed with a combination of inverted interrupted 3-0 Monocryl as well as a running 5-0 nylon suture.

I really appreaciate anybody help with coding.