# Correct cpt for a limited thoracotomy w/ evacuation of hemathorax



## cbryan (Aug 19, 2009)

I'm having trouble finding the correct cpt code that I should use for surgery that was performed by one of our surgeons.  He did a thoracoscopy and limited thoracotomy w/ evacation of hemothorax and also removed a portion of the patients rib.  Any suggestions??? Thanks


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## anihoney (Jun 2, 2011)

*Hi*

I think we can take 32150. But not sure


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## sballard (Jan 17, 2014)

*thoracotomy  see attached op note. what would the code/codes be?*

OPERATION:
1.  Left thoracotomy
2.  Repair of paraesophageal hernia
3.  Belsey Mark V fundoplication

PROCEDURE:  After having obtained informed consent, the patient was taken to the
operating room and placed on the operating room table in the supine position.  After
placement of appropriate monitoring lines, general endotracheal anesthesia was
induced and a double lumen endotracheal tube was placed.  Appropriate time-out was
taken and the patient was turned in the full right lateral decubitus position.  The
left chest was then prepped and draped in the usual sterile fashion.  A limited
partial muscle sparing left thoracotomy was performed through the sixth intercostal
space.  On exploration the hernia was noted medially and inferiorly and the inferior
pulmonary ligament was divided.  The esophagus was dissected up above the area of
the hernia and surrounded with a Penrose drain.  Dissection was then carried down
inferiorly up towards the pulmonary vessels and then inferiorly down to the hernia.
The hernia sac was fully dissected free from the pericardium diaphragm and was
partially removed.  The crural edges were identified and dissected free for repair
of the hernia.  Diaphragm was dissected free anteriorly.  At this point then the
gastroesophageal junction was identified and the fat pad was fully dissected off of
this area.  Next, crural stitches were placed posterior of #0 silk.  These stitches
were interrupted figure-of-eight sutures but remained untied to finish the
fundoplication.  At this point then the Belsey Mark IV fundoplication was done again
with 0 silk using two rows and a 240 degree wrap.  The final row of stitches was
through the diaphragm and these were snugged down but not tied at this point.  The
crural stitches were then sequentially tied down to finger-tip tightness around the
esophagus with an orogastric tube in place.  Once this was achieved the
fundoplication stitches were tied with good reduction down below the diaphragm.  No
obvious gaps in the closure.  The chest cavity was then copiously irrigated with
normal saline.  Blood loss was approximately 300 mL.  An On-Q Marcaine pump was
placed posteriorly in the subpleural space and a single 24 French chest tube for
drainage.  Chest was then closed in the usual fashion with Mersilene intercostal
sutures, PDS muscle and fascial closure and skin staples.  Patient tolerated the
procedure well.  She was extubated and taken to the PACU in satisfactory and stable
condition.


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