shanhockyfan
Guest
Ok, I have spent over an hour trying to find any codes that will cover the neurectomies. Here is the OP note:
"I injected the skin with 0.5% ropivacaine plain and made an incision right in the area of the previous incision from the rib resection. I dissected through the dermis and subq fat until i identified the trapezius and latissimus muscles. I retracted these out of the way and continued dissecting through the fascial layers until i identified the intercostal muscles. I identified the 7th, 8th and 9th ribs and began working on the 7th rib by dividing the intercostal muscle attachments to the inferior portion of the rib. i identified immediately the neurovascular bundle. i clampled this proximally and distally and then removed about 1 cm of the neurovascular bundle. i ligated both ends w/ 2-0 silk suture. Same procedure for the 9th rib. Because of the prior surgery, after dividing the intercostal muscles from the 8th rib, i was unable to clearly identify a neurovascular bundle. i sent off some tissue to determine if nerve was present in it, but nothing that i could clearly confidently say that was a neurovascualr bundle. I removed 2 cm of the rib so that i could better inspect the area around the rib, but still could not find a neurovascualr bundle."
My provider then closed w/ no problems. i just have NO idea where to find the excision of the nerve bundles!!!
Any help would be very helpful in my finding my way through this surgery. Thanks
"I injected the skin with 0.5% ropivacaine plain and made an incision right in the area of the previous incision from the rib resection. I dissected through the dermis and subq fat until i identified the trapezius and latissimus muscles. I retracted these out of the way and continued dissecting through the fascial layers until i identified the intercostal muscles. I identified the 7th, 8th and 9th ribs and began working on the 7th rib by dividing the intercostal muscle attachments to the inferior portion of the rib. i identified immediately the neurovascular bundle. i clampled this proximally and distally and then removed about 1 cm of the neurovascular bundle. i ligated both ends w/ 2-0 silk suture. Same procedure for the 9th rib. Because of the prior surgery, after dividing the intercostal muscles from the 8th rib, i was unable to clearly identify a neurovascular bundle. i sent off some tissue to determine if nerve was present in it, but nothing that i could clearly confidently say that was a neurovascualr bundle. I removed 2 cm of the rib so that i could better inspect the area around the rib, but still could not find a neurovascualr bundle."
My provider then closed w/ no problems. i just have NO idea where to find the excision of the nerve bundles!!!
Any help would be very helpful in my finding my way through this surgery. Thanks