kdsampson
Networker
I'm not sure what to use for this procedure:
Patient underwent L3-4 posterior fusion two weeks ago and presented with a large compressive epidural hematoma at the L3-4 level.
I made an incision over the old incision line and removed all of the sutures as I dissected my way down through the fascia. I was then immediately able to identify a very large hematoma; this was under much pressure under the fascia and was causing significant thecal sac compression. I was able to remove the hematoma in a piece meal fashion. I thoroughly irrigated the wound. When I was happy with the decompression and the removal of the hematoma I maintained hemostasis; I used bipolar and FloSeal to do this. When I was finished there was no further bleeding or neural compression. I did opt to place a drain; I sewed the drain into place and closed the wound in my usual layered fashion...
I've heard Margie Vaught with Decision Health's presentation and 22015 is for abscesses only per that. 10140 is too superficial for this. Do I use 11043 or unlisted?
Any help is greatly appreciated.
Patient underwent L3-4 posterior fusion two weeks ago and presented with a large compressive epidural hematoma at the L3-4 level.
I made an incision over the old incision line and removed all of the sutures as I dissected my way down through the fascia. I was then immediately able to identify a very large hematoma; this was under much pressure under the fascia and was causing significant thecal sac compression. I was able to remove the hematoma in a piece meal fashion. I thoroughly irrigated the wound. When I was happy with the decompression and the removal of the hematoma I maintained hemostasis; I used bipolar and FloSeal to do this. When I was finished there was no further bleeding or neural compression. I did opt to place a drain; I sewed the drain into place and closed the wound in my usual layered fashion...
I've heard Margie Vaught with Decision Health's presentation and 22015 is for abscesses only per that. 10140 is too superficial for this. Do I use 11043 or unlisted?
Any help is greatly appreciated.