jfolz
Networker
Hi all,
I am looking for more information in coding a procedure the physician is calling "chelation of C++ Band keratopathy" and the use of a "Gunderson pedicle conjunctival graft" both procedures (graft placement and harvest as well) same eye.
Abbreviated Op note below-
Pt has a history or multiple surgeries to the eye including cataract removal and penetrating corneal transplant and has now developed poor vision, persistant pain, and C++ band keratopathy.
Pt is prepped and draped, anesthesia administered. "The conjunctiva was elevated, a pedicle conjunctival graft was fashioned with scissors and forceps and the dissection was carried to the limbus. The graft measured 12x12 mm in area with the attached pedicle superior nasally and superior temporally in a "bucket handle" fashion. The epithelium on the cornea was removed after placing 20% ethanol on the cornea. This allowed the removal with a #54 Beaver blade. The calcium was chelated with the use of a corneal protector soaked in 3% Di-sodium EDTA. the solution was replenished for five 1 minute applications. With some scraping of the flakes of calcium, this ultimately removed the visible band nicely."
Then we get... "During the dissection and manipulation of the cornea, the old cataract wound dehisced. It was easily sutured and secured with several interrupted 10-0 nylon sutures."
And back to the original procedure..."The graft was sutured into place with nylon sutures. The bites were placed through stromal tissue at the limbus near 8:00 and 10:00. Several sutures were also placed through the epi-scleral tissue nasally. This secured the graft nicely." Eye is patched and taped, patient sent to recovery.
Any information on the procedure, any codes to consider, or a link to any literature anyone might have available would be so greatly appreciated!!
I code for a multi-specialty Outpatient Surgery Center facility.
At the moment, I am considering 65400 for the Keratopathy but not sure that condition would really be considered a corneal lesion...and maybe 68399 for the conjunctival graft?
Thanks in advance!
I am looking for more information in coding a procedure the physician is calling "chelation of C++ Band keratopathy" and the use of a "Gunderson pedicle conjunctival graft" both procedures (graft placement and harvest as well) same eye.
Abbreviated Op note below-
Pt has a history or multiple surgeries to the eye including cataract removal and penetrating corneal transplant and has now developed poor vision, persistant pain, and C++ band keratopathy.
Pt is prepped and draped, anesthesia administered. "The conjunctiva was elevated, a pedicle conjunctival graft was fashioned with scissors and forceps and the dissection was carried to the limbus. The graft measured 12x12 mm in area with the attached pedicle superior nasally and superior temporally in a "bucket handle" fashion. The epithelium on the cornea was removed after placing 20% ethanol on the cornea. This allowed the removal with a #54 Beaver blade. The calcium was chelated with the use of a corneal protector soaked in 3% Di-sodium EDTA. the solution was replenished for five 1 minute applications. With some scraping of the flakes of calcium, this ultimately removed the visible band nicely."
Then we get... "During the dissection and manipulation of the cornea, the old cataract wound dehisced. It was easily sutured and secured with several interrupted 10-0 nylon sutures."
And back to the original procedure..."The graft was sutured into place with nylon sutures. The bites were placed through stromal tissue at the limbus near 8:00 and 10:00. Several sutures were also placed through the epi-scleral tissue nasally. This secured the graft nicely." Eye is patched and taped, patient sent to recovery.
Any information on the procedure, any codes to consider, or a link to any literature anyone might have available would be so greatly appreciated!!
I code for a multi-specialty Outpatient Surgery Center facility.
At the moment, I am considering 65400 for the Keratopathy but not sure that condition would really be considered a corneal lesion...and maybe 68399 for the conjunctival graft?
Thanks in advance!
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