Wiki Eyelid, Eyebrow, Orbicularis occulus muscle repair.

bailsb

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I don't code many of these so I wanted to try and get some help. Any help is greatly appreciated.

My codes: 14040, 67399-51, 12015-59 (Not so sure about the use of 67399)

Sever laceration of the left lateral orbital zygomatic complex with a large hematoma present.

Principle Procedures:
1. Repair, orbicularis oculus muscle, upper eyelid 5 cm.
2. Repair, tissue rearrangement, left zygomatic temporal dermal tear lacerations with a W-plasty in a 6 cm multi-tissue area.
3. Repair, left upper lateral eyelid 3 cm.
4. Repair, left lateral eyebrow temporal sweep 3.5 cm.

Procedure:
Under a field block, anesthetic 1% xylocaine, the area was infiltrated.
It was irrigated with a large amount of betadine and saline solution. Old hematoma was removed.

The orbicularis oculus muscle of the left upper eyelid was repaired with interrupted 6-0 vicryl sutures in a 5 cm area extending from the upper lateral portion all the way out to the temporal region. After the orbicularis oculus was repaired, then a tissue rearrangement of multi-flapped dermal terar measuring 6 cm was done, rotating tongues of tissue across the midline with interrupted 6-0 vicryl suture, so as to prevent the indetation and the angulation of the scar. After this 6-0 vicryl sutures were laid in the entire 6 cm of scar, then the wound edges were approximated with the 5-0 fast – absorbing gut suture.

The left upper lateral eyelid, 3 cm laceration was repaired in an interrupted fashion using 6-0 vicry intracuticularly and 5-0 fast-absorbing suture on the skin surface.

A 3.5 cm area, which is extended from the lateral eyebrow out int the temporal recess was also repaired with the interrupted 6-0 vicryl intracuticularly and 5-0 fast absorbing gut suture on the skin surface.

The wounds were cleansed again and a telfa guaze antibiotic ointment using bactroban was then applied with half-inch paper. Mastisol at the edges.

Thank you,
Brendan Bailey, CPC
 
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