Here is this from the HPI I am confused on whether to use 64595 or 64590, both codes are for replacement... arghhhh. Thanks
MB,CCS,CPC
Depleted battery
Plan:
Options were reviewed with the patient
I made sure that she had realistic expectations and understood alternatives. She does want to proceed with surgery.
Exchange battery plus/minus lead.
PREOPERATIVE DIAGNOSIS(ES):
Malfunction of InterStim.
POSTOPERATIVE DIAGNOSIS(ES):
Malfunction of InterStim.
Surgeon:
Assistant(s): none
ANESTHESIA:
Local lidocaine with monitored anesthesia care.
COMPLICATIONS:
None.
Specimens:
None
EBL: miminal
INDICATIONS: The patient has elected to proceed with Interstim revision. Risks,
Including lead fracture have been reviewed.
PROCEDURE(S)/OPERATION(S) PERFORMED:
1. Placement of sacral neurostimulator, 64590.
2. Removal of sacral neurostimulator, 64595.
3. Intraoperative device programming analysis, simple, 95971.
FINDINGS:
There were no complications.
SUMMARY:
The patient was carefully positioned in the prone position, prepped and
draped in a standard sterile manner with chlorhexidine, alcohol and
ChloraPrep. The skin incisions were marked with a marking pen. The skin
and subcutaneous tissue around the planned incisions were infiltrated with
1% lidocaine. Over the patient's existing stimulator pocket, the incision
was carried down to the level of the capsule. The patient's existing
stimulating unit was extracted.
A new neurostimulator was then placed in the right buttocks pocket. The
device was interrogated. The device was analyzed and programmed. Impededance was normal.
All leads were operational. Lead one selected.
Copious antibiotic irrigation had been utilized. The wounds
were closed in layers with 3-0 Biosyn, 4-0 Biosyn, and 4-0 Biosyn
subcuticular. Mastisol, Steri-Strips, Telfa, and Tegaderm were applied.
The patient tolerated this procedure well. All counts were correct.
MB,CCS,CPC
Depleted battery
Plan:
Options were reviewed with the patient
I made sure that she had realistic expectations and understood alternatives. She does want to proceed with surgery.
Exchange battery plus/minus lead.
PREOPERATIVE DIAGNOSIS(ES):
Malfunction of InterStim.
POSTOPERATIVE DIAGNOSIS(ES):
Malfunction of InterStim.
Surgeon:
Assistant(s): none
ANESTHESIA:
Local lidocaine with monitored anesthesia care.
COMPLICATIONS:
None.
Specimens:
None
EBL: miminal
INDICATIONS: The patient has elected to proceed with Interstim revision. Risks,
Including lead fracture have been reviewed.
PROCEDURE(S)/OPERATION(S) PERFORMED:
1. Placement of sacral neurostimulator, 64590.
2. Removal of sacral neurostimulator, 64595.
3. Intraoperative device programming analysis, simple, 95971.
FINDINGS:
There were no complications.
SUMMARY:
The patient was carefully positioned in the prone position, prepped and
draped in a standard sterile manner with chlorhexidine, alcohol and
ChloraPrep. The skin incisions were marked with a marking pen. The skin
and subcutaneous tissue around the planned incisions were infiltrated with
1% lidocaine. Over the patient's existing stimulator pocket, the incision
was carried down to the level of the capsule. The patient's existing
stimulating unit was extracted.
A new neurostimulator was then placed in the right buttocks pocket. The
device was interrogated. The device was analyzed and programmed. Impededance was normal.
All leads were operational. Lead one selected.
Copious antibiotic irrigation had been utilized. The wounds
were closed in layers with 3-0 Biosyn, 4-0 Biosyn, and 4-0 Biosyn
subcuticular. Mastisol, Steri-Strips, Telfa, and Tegaderm were applied.
The patient tolerated this procedure well. All counts were correct.