# Parapharyngeal Space Mass excision



## gbaynham (Dec 17, 2013)

Can someone please assist with coding of PPS mass?  My physician coded as 61605 however no mention of osteotomy.  He did a neck dissection level II for access.  The neck was incised, fascia reflected anteriorly & superiorly off of SCM muscle medially to the internal jugular vein.  Jugular vein was then reflectected and the vagus was identified.  We identified the accessory nerve & hypoglossal was superior to both of these nerves, sweeping across the jugular vein.  The fibrofatty tissue within level two was dissected off the neurovascular structures and sent off as level 2 for permanent sectioning.  They continued the dissection deep to submandibular gland & anterior to internal carotid.  The parapharyngeal space mass was identified, was a shiny pearly light encapsulated lesion.  Was circumferentially dissected around the parapharyngeal mass and mass completely excised in one piect.  We then re-identified all fo the cranial nerves and verified that these were all intact.  ..... proceded with closure of dermis, epidermis.  
Thoughts?????


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