Wiki Attempted Robotic Takedown of Lima

[dpumford]

The patient was to have a Robotic Cabg w/lima.

Because of the pt's severe restrictions a sternotomy could not be considered.

Three 1-cm incisions were taken. Robotic arms were docked. Because of the significant scoliosis and rotation of the heart towards the chest wall. The robotic takedown could not be accomplished since the heart was coming in the way and everytime we tried to displace it posteriorly, she developed significant ectopy and drop in blood pressure.

Despite repeated attempts to take the IMA down we were not successfull.

I am not confidient if 33533-53 would be correct.

Any suggestions??

Thanks in Advance~

 

[jewlz0879]

The patient was to have a Robotic Cabg w/lima.

Because of the pt's severe restrictions a sternotomy could not be considered.

Three 1-cm incisions were taken. Robotic arms were docked. Because of the significant scoliosis and rotation of the heart towards the chest wall. The robotic takedown could not be accomplished since the heart was coming in the way and everytime we tried to displace it posteriorly, she developed significant ectopy and drop in blood pressure.

Despite repeated attempts to take the IMA down we were not successfull.

I am not confidient if 33533-53 would be correct.

Any suggestions??

Thanks in Advance~

My physician performs CABGs all the time just never with the robotic arms. I agree with what you've chosen. Modifier -53 is not for elective cancellation of a procedure prior to pateints anesthesia induction and/or surgical preperation; it is however for extenuating cirsumstances which affect the well-being of the patient. He documents the patients develops significant ectopy and hypotension. The procedure was started and he stopped it early. I would agree with what you have.

 

[dpumford]

Thanks so much for your response!

That is what I endend up coding ....

Thanks again!