mhefner5
Contributor
I am having a bit of trouble coding out a situation where the doctor has lipo'd out abdominal fat and injecting it into the pt lip. I am saying that the centrifuging (preparation) of the fat is included into the lipo code, but because it is not stated in the extended description of the code 15877, we are having a little bit of conflict regarding the centrifuge.
Procedure: Autologous fat transfer from the epigastrium to the left upper lip and to the left filtral column.
After being marked in the upright position the pt was placed in the supine position, she was infiltrated w/ approximately 200cc of standard tumescent solution to the left and right epigastric area after she had been prepped w/betadine and draped in the usual fashion. Coleman type aspirator and 10 cc of syringe was used to aspirate a total of 3cc of 10cc of aspirate, each of which were spun down to obtain a total of about 3cc of very healthy fat and stromovascular components. These 3 were then drained of their excess fluid/oils and were centrfuged for 2min and then the facial area was prepped w/zephiran chloride and draped in the usual fashion. Bilateral oral commissure incisions measuring approx 1.5mm at the most were made, undermining with a blunt tipped Coleman small cannula was utilized and then most of the infiltration of the fat was done from teh left oral commissure of the undermined area totaling on the initial instillation .45cc. Then the filtral area was incised where the Cupids bow would end on the left, this having been previously ablated the the injury. The filtral column on the left was then recreated by means of undermining and then infiltration w/ approx .1cc. Lastly the approach from the lateral oral commissure was made undermining only the vermillion area with the cannula and then the cannula proceeded medially to the sub scar area. The scar was further broken up by means of undermining with the blunt tipped cannula and then a total of .1cc was infiltrated into that area.
So there is the op-report. Pt was bit by a dog.
ANY input is greatly appreciated!!!!!!!!!!!!!!!!!!!!!!
Procedure: Autologous fat transfer from the epigastrium to the left upper lip and to the left filtral column.
After being marked in the upright position the pt was placed in the supine position, she was infiltrated w/ approximately 200cc of standard tumescent solution to the left and right epigastric area after she had been prepped w/betadine and draped in the usual fashion. Coleman type aspirator and 10 cc of syringe was used to aspirate a total of 3cc of 10cc of aspirate, each of which were spun down to obtain a total of about 3cc of very healthy fat and stromovascular components. These 3 were then drained of their excess fluid/oils and were centrfuged for 2min and then the facial area was prepped w/zephiran chloride and draped in the usual fashion. Bilateral oral commissure incisions measuring approx 1.5mm at the most were made, undermining with a blunt tipped Coleman small cannula was utilized and then most of the infiltration of the fat was done from teh left oral commissure of the undermined area totaling on the initial instillation .45cc. Then the filtral area was incised where the Cupids bow would end on the left, this having been previously ablated the the injury. The filtral column on the left was then recreated by means of undermining and then infiltration w/ approx .1cc. Lastly the approach from the lateral oral commissure was made undermining only the vermillion area with the cannula and then the cannula proceeded medially to the sub scar area. The scar was further broken up by means of undermining with the blunt tipped cannula and then a total of .1cc was infiltrated into that area.
So there is the op-report. Pt was bit by a dog.
ANY input is greatly appreciated!!!!!!!!!!!!!!!!!!!!!!