rpettigrewcpc
Contributor
Patient had an extensive open therapeutic wedge resection 32505 (Modifier 22 used as it took 2 hours to free the lung from adhesions).
Immediately after closing the chest, the surgeon noticed an extensive airleak and reopened the chest and repaired it.
I need help on how to code the reopening/repair please????? CPT 32120 is what I initially looked at, but I believe the patient has to actually have left the operating room to use this.
Thoughts / Help?
Relevant portion of the Operative Report:
After the thoracotomy incision was closed and dressed, I noted that there
was a massive amount of air leak coming through the Pleur-Evac. I
expected air leak because of the extensive lysis of adhesions, but this
was quite substantial. I elected to reopen the thoracotomy incision to
explore and perhaps control some of the air leak. The staplers were
removed and the thoracotomy incision was reopened and a Finochietto
retractor was replaced. The chest cavity was filled with warm saline
solution and I noted some areas that had quite a bit of air leak. A 3-0
Vicryl was used to oversew these areas and topical Progel was applied
generously at these areas. The thoracotomy incision was then closed back
in a similar fashion as above. This time I noted that there was far less
air leak in the Pleur-Evac. The patient was then transferred to the
recovery room in stable condition. Instrument, sponge and needle counts
were correct at the end of the operative procedure.
Immediately after closing the chest, the surgeon noticed an extensive airleak and reopened the chest and repaired it.
I need help on how to code the reopening/repair please????? CPT 32120 is what I initially looked at, but I believe the patient has to actually have left the operating room to use this.
Thoughts / Help?
Relevant portion of the Operative Report:
After the thoracotomy incision was closed and dressed, I noted that there
was a massive amount of air leak coming through the Pleur-Evac. I
expected air leak because of the extensive lysis of adhesions, but this
was quite substantial. I elected to reopen the thoracotomy incision to
explore and perhaps control some of the air leak. The staplers were
removed and the thoracotomy incision was reopened and a Finochietto
retractor was replaced. The chest cavity was filled with warm saline
solution and I noted some areas that had quite a bit of air leak. A 3-0
Vicryl was used to oversew these areas and topical Progel was applied
generously at these areas. The thoracotomy incision was then closed back
in a similar fashion as above. This time I noted that there was far less
air leak in the Pleur-Evac. The patient was then transferred to the
recovery room in stable condition. Instrument, sponge and needle counts
were correct at the end of the operative procedure.
