# Chest tube removal & replacement



## suela923@aol.com (Apr 29, 2013)

I was thinking of coding this as 49423, 75984 but it's not exactly right and I thought we weren't suppose to code it "as close".  Any suggestions?  Thank you!


  Left chest tube removal and repositioning with replacement under fluoroscopic guidance

History: Left chest tube exchange. Worsening subcutaneous emphysema with chest tube in place for treatment of pneumothorax. COPD.

Technique: Timeout was performed. Skin over the left chest was prepped and draped sterilely; 2% lidocaine was used as a local anesthetic. Scout x-ray was performed. The existing chest tube was removed over a wire and the wire was repositioned to the left lung apex. Over this wire, a new 8-French Skater catheter was placed. Final x-ray of the chest was obtained. Patient tolerated the procedure well with no complications.

Findings: Scout x-ray shows a left chest tube in the left mid chest with a small pneumothorax and subcutaneous emphysema. New 8-French catheter was placed with tip in the left lung apex in excellent position. No change in subcutaneous emphysema. Pneumothorax is not well demonstrated.

IMPRESSION:


Successful and uncomplicated left chest tube repositioning and replacement as described above.


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## TWinsor (May 1, 2013)

Does 32557 work for you?


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