bluebird301@gmail.com
Guest
- Messages
- 9
- Best answers
- 0
Hi All, I am coding the below : The procedure was done in conjunction with Reverse TSA. This does not, to me, sound like CPT 24301 and I am curious what your thoughts are?
"The right shoulder and arm was then prepped and draped in the usual sterile fashion. An anterior deltopectoral
approach was used. The incision was carried down through the subcutaneous tissue. Cephalic vein was
identified and retracted laterally with Browne retractor in the deltoid. Pectoralis major muscle and tendon were
identified. It was released from the humerus in the upper 2 cm. The Alexis soft tissue protector was then placed
under the pectoralis major muscle and tendon and deltoid. Browne retractor was then placed again under the
deltoid. The clavipectoral fascia was released. The conjoined tendon was then retracted medially. The latissimus
dorsi tendon was then harvested. The pectoralis major tendon was taken further down off of the humerus to
fully expose the latissimus dorsi tendon. This was a nice thick latissimus dorsi tendon that was well attached. It
was released off the insertion site of the humerus using #15 blade while protecting the neurovascular structures
in the axilla. The tendon was then secured with two #2 Force Fiber sutures along each side of the tendon using a
locking Krakow fixation stitch to secure the tendon fixation for about 2 cm on either side of the tendon. The
tendon was then mobilized along the myotendinous junction down to the neurovascular structures. The tendon
had good mobility. A large curved clamp was then placed around the humeral neck keeping the clamp on bone in order to avoid the neurovascular structures.
This was then used to pass a suture to transfer the tendon to the external surface of the greater tuberosity."
"The right shoulder and arm was then prepped and draped in the usual sterile fashion. An anterior deltopectoral
approach was used. The incision was carried down through the subcutaneous tissue. Cephalic vein was
identified and retracted laterally with Browne retractor in the deltoid. Pectoralis major muscle and tendon were
identified. It was released from the humerus in the upper 2 cm. The Alexis soft tissue protector was then placed
under the pectoralis major muscle and tendon and deltoid. Browne retractor was then placed again under the
deltoid. The clavipectoral fascia was released. The conjoined tendon was then retracted medially. The latissimus
dorsi tendon was then harvested. The pectoralis major tendon was taken further down off of the humerus to
fully expose the latissimus dorsi tendon. This was a nice thick latissimus dorsi tendon that was well attached. It
was released off the insertion site of the humerus using #15 blade while protecting the neurovascular structures
in the axilla. The tendon was then secured with two #2 Force Fiber sutures along each side of the tendon using a
locking Krakow fixation stitch to secure the tendon fixation for about 2 cm on either side of the tendon. The
tendon was then mobilized along the myotendinous junction down to the neurovascular structures. The tendon
had good mobility. A large curved clamp was then placed around the humeral neck keeping the clamp on bone in order to avoid the neurovascular structures.
This was then used to pass a suture to transfer the tendon to the external surface of the greater tuberosity."