# Thoracotomy



## knperry (Aug 19, 2013)

I need help coding this surgery have several codes but not sure which ones to use.  The surgery notes are below:

Procedure Performed:

right-sided anterolateral thoracotomy
decortication of right lung


Patient was taken to the operating room, placed supine on the operating room table.  the right-sided intrude internal jugular triple-lumen catheter was placed per anesthesia, see anesthesia record.  An A-line was placed in the right radial artery, see anesthesia record.  The single-lumen tube was exchanged for a double-lumen tube, see anesthesia record.  the right chest was prepped and draped in sterile fashion after the patient was positioned right side up.  her right-sided anterolateral thoracotomy incision was made directly beneath the scapula.  The bovie cautery was used to dissect down through the muscle layers of the right chest wall, preserving the serratus anterior muscle.  The right lung was dropped and the right chest cavity was entered.  Upon entering the right chest cavity, a large amount of necrotic-looking pus was suctioned and drained.  Finochietto retractor was used to give adequate exposure iin the chest and some adhesions were taken down with blunt gentle dissection with our hands.  The lung was then freed along its lateral border.  In an attempt to free along inferiorly where the diaphragmatic repair has taken place we had to make a counter incision 2 ribs below our initial thoracotomy incision in the ribs.  Finochietto retractor was placed inferiorly in this new rib incision and adhesions weer taken down bluntly as well.  after this was done, the lung was inflated and there appeared to be several small air leaks from the lung where the rind had been taken off of the lung in the chest wall (our decortication).  These holes were repaired with 3-0 prolene pledgeted sutures in and interrupted fashion in 3 separate places.  Lung was again reinflated and there appeared to be no longer air leak from these spots. 

There are also tube placements but I have the codes for that. 

Thank for the help!


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## AWright421 (Aug 27, 2013)

32220


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## knperry (Sep 3, 2013)

Thank you!


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