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Having trouble finding a code for Excision of facial/skull boney exostosis?
ESCRIPTION OF PROCEDURE: The patient was taken to the operating room and
placed in supine position. After proper preprocedure timeout was
performed, the patient underwent general anesthesia. All bony prominences
and pressure points were padded. SCDS and Bair Hugger were applied. The
patient received a preoperative dose of antibiotics. The patient was then
prepped and draped in the usual sterile fashion after being injected with
local as per above. An incision excising the old scar over the area from
her previous incision and drainage was done and then this was extended
down through the periosteum, exposing the area. This was all done with a
15 blade scalpel. Then, using a Freer elevator, the periosteum was lifted
away from this bony exostosis. Using a chisel and hammer, this area was
recontoured down, taking care to not violate the plug space. Once I was
satisfied with the contour; and using a small rasp, the area was rasped
down. The pocket was then copiously irrigated and then the incision was
closed with inverted interrupted galeal sutures of 3-0 Vicryl and then
inverted interrupted simple sutures of 4-0 Ethilon. Bacitracin was
applied. At the end of the case, all needle, sponge, and instrument
counts were correct. The patient emerged from anesthesia, was taken to
the PACU in stable condition.
FOLLOWUP INSTRUCTIONS: The patient will follow up in clinic in 2 weeks
for removal of the sutures and review pathology. She was given all
instructions and verbalized understanding.
ESCRIPTION OF PROCEDURE: The patient was taken to the operating room and
placed in supine position. After proper preprocedure timeout was
performed, the patient underwent general anesthesia. All bony prominences
and pressure points were padded. SCDS and Bair Hugger were applied. The
patient received a preoperative dose of antibiotics. The patient was then
prepped and draped in the usual sterile fashion after being injected with
local as per above. An incision excising the old scar over the area from
her previous incision and drainage was done and then this was extended
down through the periosteum, exposing the area. This was all done with a
15 blade scalpel. Then, using a Freer elevator, the periosteum was lifted
away from this bony exostosis. Using a chisel and hammer, this area was
recontoured down, taking care to not violate the plug space. Once I was
satisfied with the contour; and using a small rasp, the area was rasped
down. The pocket was then copiously irrigated and then the incision was
closed with inverted interrupted galeal sutures of 3-0 Vicryl and then
inverted interrupted simple sutures of 4-0 Ethilon. Bacitracin was
applied. At the end of the case, all needle, sponge, and instrument
counts were correct. The patient emerged from anesthesia, was taken to
the PACU in stable condition.
FOLLOWUP INSTRUCTIONS: The patient will follow up in clinic in 2 weeks
for removal of the sutures and review pathology. She was given all
instructions and verbalized understanding.