Wiki Chest Wal Mass?

codedog

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Marrero, LA
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Not sure on this one . Would 21555 fit this , or 11602 ? Path report came back recurrent inflltrating ductal carcinoma.

PREOPERATIVE DIAGNOSIS: Right chest wall mass.

POSTOPERATIVE DIAGNOSIS: Right chest wall mass.

PROCEDURE PERFORMED: Excision of right chest wall mass.

ANESTHESIA: LMA.

OPERATIVE PROCEDURE: The patient was brought into the operating room and placed supine on the operating table. Her right chest was prepped and draped in the standard sterile fashion. The mass, which was within her prior mastectomy scar was palpated. Local anesthetic was injected beneath the skin. An incision was made using a #15 blade. Dissection was carried down to fascia using Bovie electrocautery and then dissected off of the fascia using Bovie electrocautery. Hemostasis was achieved. Due to the extensive scar tissue, more inferior skin was dissected off of the fascia to allow for assistance in skin closure. Subcutaneous suture was placed using interrupted 3-0 Vicryl. Then, the skin was closed using combination of horizontal mattress and simple interrupted suture using 3-0 nylon. The surgical wound was then dressed using sterile gauze and Tegaderm. All needle and sponge counts were correct x2. . The patient was awakened from anesthesia and brought into the PACU in stable condition. There were no complications. Estimated blood loss was less than 5 cc.
 
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