# Ct guided renal cyst ablation / aspiration x 4



## chembree (Jun 18, 2012)

CT GUIDED RENAL CYST ABLATION / ASPIRATION X 4

   HISTORY: Bilateral symptomatic large renal cyst 2 right kidney, 2 left
   kidney.

   COMPARISON: None

   MEDICATIONS:  Fentanyl and Versed were titrated to effect for moderate
   sedation. Direct face to face sedation was provided under my supervision
   for approximately 45 minutes. 

   PROCEDURE:The risks, benefits, and alternatives to the procedure and
   moderate sedation were explained to the patient, and informed written
   consent was obtained.   

   Pre procedure CT scout images  with the patient in the prone position
   demonstrates bilateral large cyst. There are 2 large cyst left kidney
   upper pole up to 7.2 cm in dimension and lower pole of two 6.1 cm in
   dimension. There are 2 large right renal cyst upper pole 5.5 cm and
   lower pole smaller 3.6 cm. 

   The skin overlying the lesions were marked for appropriate site for
   entry. The back was prepped and draped in the usual sterile fashion.  A
   procedural pause was performed and 2% lidocaine was used as local
   anesthetic.  A 5 French pigtail UV catheters were utilized at the 4
   sites into the fourth cyst. 20 mL of thin yellow fluid was obtained from
   all 4 of the cyst and sent to laboratory for cytology examinations with
   each syringe marked appropriately. Next 80 additional mL were withdrawn
   from the upper pole left renal cyst and 80 mL from the upper pole and
   the lower pole right renal cysts were removed. 

   Following this 10 mL dehydrated absolute alcohol was then slowly
   delivered into each of these cysts though the left lower pole cyst the
   if needed only 5 mL given its small size. The alcohol was left in place
   for a total of 10 minutes. After 10 minutes an additional 45 mL of fluid
   was removed from the upper pole right renal cysts and 23 mL additional
   fluid removed from the lower pole right renal cyst and 35 mL was removed
   from the upper pole left renal cyst. 7 mL was removed the lower pole
   left renal cyst.

   Postprocedure scanning showed complete resolution of all cystic
   structures without evidence of residual cystic lesion identified. There
   are cortical atrophic changes related to long-standing suggest present.
   There were no signs of complication. The patient exhibited minimal pain
   during the procedure which was well tolerated. Sterile dressings were
   applied.  The patient tolerated the procedure well with no immediate
   complications and was discharged from the procedure in stable condition.


   IMPRESSION: Successful CT guided aspiration and ablation of 4 renal
   cysts as described.

   Thank you for referring patient to Interventional Radiology for their
   procedure and allowing me to participate with you in their care.
________________________________________

http://www.zhealthpublishing.com/free_medical_coding_info/free_coding_newsletter/archive/201101.htm

Can someone verfy my codes for me? My main question is... would you code the surgical code  once per cyst?

*53899
53899
53899
53899
77013-26
99144
99145*


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