# Excision of right preauricular sinus tract



## hstefani

I need help coding this surgery. 
Our facility coders are saying it should be 11442. The physician is trying to use 42815.  I don't think either work well but unfortunately, I cannot find anything that sounds better! Any thoughts?   Here is the op note. 

The patient was taken to the operating room and placed 
supine on the operating room table. After general anesthesia was induced, table 
was rotated 90 degrees. The patient had received IV antibiotics. The area around
the right preauricular pit and an anterior scar from previous incision and 
drainage was injected with 1% lidocaine with 1:100,000 epinephrine. The ear was 
then prepped and draped in the usual sterile fashion. A lacrimal probe was used 
to probe the sinus tract and this extended approximately 1.5 cm into the deep 
soft tissue. An elliptical incision was made around the sinus tract opening and 
then using sharp dissection I dissected the tract inferiorly and deeply using 
the lacrimal probe as my guide to prevent entry into the sinus tract itself. The
tract extended along the cartilage surface deep to the root of the helix. It 
abruptly stopped at the helical cartilage in this area and was sharply removed 
from the cartilage perichondrium. The specimen was sent to the pathology 
department. There was some minimal point bleeding controlled with bipolar 
cautery. The parotid fascia appeared intact and had not been violated during the
dissection. I then closed the incision with interrupted 4-0 Monocryl suture 
followed by Mastisol and Steri-Strips. The facial nerve monitoring electrodes 
were removed from the orbicularis oculi and oris and had been used to monitor 
facial nerve throughout the entire case. The patient tolerated the procedure 
well and was extubated and taken stable to the PACU.


Anything would be helpful at this point. Thank you


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