bennieyoung
Guru
I could use some help with coding this. My attempts have resulted in a denial from Insurance and I would really appreciate someone else's take on this. Thanks so much for your time!
Double-lumen endotracheal tube and Foley were placed. I made a muscle sparing lateral thoracotomy in the 5th intercostal space. Upon entering the chest, there was a liter of serous fluid. Upon removing the fluid, there was a very dense adherent pleural peel which took some time to decorticate the lower lung. We avoided going anterior to avoid his previous left internal mammary artery, and freed up the lung as much as we could circumferentially. Upon opening the chest with opening the ribs, the diaphragm poor, which was extremely fibrosed up in the corner there, and was repaired with a pericardial patch.Two chest tubes were placed. We also did intercostal cryoablation above and below and at the rib level, as well as Marcaine with epinephrine. The chest because of his large physical nature, and history of a heavy weightlifting, was closed with a stainless steel wire, the subcu tissue was closed with Vicryl, the skin was closed in a standard fashion.
Double-lumen endotracheal tube and Foley were placed. I made a muscle sparing lateral thoracotomy in the 5th intercostal space. Upon entering the chest, there was a liter of serous fluid. Upon removing the fluid, there was a very dense adherent pleural peel which took some time to decorticate the lower lung. We avoided going anterior to avoid his previous left internal mammary artery, and freed up the lung as much as we could circumferentially. Upon opening the chest with opening the ribs, the diaphragm poor, which was extremely fibrosed up in the corner there, and was repaired with a pericardial patch.Two chest tubes were placed. We also did intercostal cryoablation above and below and at the rib level, as well as Marcaine with epinephrine. The chest because of his large physical nature, and history of a heavy weightlifting, was closed with a stainless steel wire, the subcu tissue was closed with Vicryl, the skin was closed in a standard fashion.