Has anyone else seen this being performed yet? Just wondering what other people are doing to bill for this. I know it's going to have to be billed using an unlisted code but what codes are you using for comparative pricing/RVU values?
INDICATION(S): Tracheoesophageal fistula
A 14 French nasogastric tube was then selected and cut short so that the last hole was approximately 2 cm from the tip. The nasogastric tube was advanced through the right nare into the oropharynx and then grasped and pulled out the mouth. The small wound VAC sponge was then cut to size and secured to the tip of the nasogastric tube with 0-silk suture. Adaptic was then secured around the sponge using 0 silk sutures. The sponge was then advanced down into the proximal esophagus with the assistance of endoscopy, and beyond the fistula into the gastric conduit. The endoscope was then pulled back until the fistula was visible at 25 cm. Under endoscopic vision, the nasogastric tube was withdrawn slowly until the sponge abutted the defect. The nasogastric tube was held firmly in place while the scope was slowly withdrawn. Negative pressure of 125mm Hg was then applied resulting in collapse of the lumen around the wound VAC sponge. The scope was withdrawn and the nasogastric tube was secured to the nose after withdrawing the excess tubing from the oropharynx.
Thanks!
INDICATION(S): Tracheoesophageal fistula
A 14 French nasogastric tube was then selected and cut short so that the last hole was approximately 2 cm from the tip. The nasogastric tube was advanced through the right nare into the oropharynx and then grasped and pulled out the mouth. The small wound VAC sponge was then cut to size and secured to the tip of the nasogastric tube with 0-silk suture. Adaptic was then secured around the sponge using 0 silk sutures. The sponge was then advanced down into the proximal esophagus with the assistance of endoscopy, and beyond the fistula into the gastric conduit. The endoscope was then pulled back until the fistula was visible at 25 cm. Under endoscopic vision, the nasogastric tube was withdrawn slowly until the sponge abutted the defect. The nasogastric tube was held firmly in place while the scope was slowly withdrawn. Negative pressure of 125mm Hg was then applied resulting in collapse of the lumen around the wound VAC sponge. The scope was withdrawn and the nasogastric tube was secured to the nose after withdrawing the excess tubing from the oropharynx.
Thanks!