Wiki Masectomy with axillary node dissection

rhmehta

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Need Help!!

Postoperative Dx: Left Breast cancer

Op Note: General anesthetic was given. She was prepped and draped in the usual sterile fashion. An incision was made encompassing the nipple-areolar complex extending medial collateral. Dissection was undertaken to make skin flaps. The flaps were raised to the clavicle, the sternum, and the infra mammary fold and then the breast was elevated off the pectorals muscle including as much as the fascia is possible.
The patient has a previous stroke and her pectoralis muscle was markedly atrophied and dissection was difficult. Continued from medial to lateral in and out to the axilla where axillary contents were dissected free, clips were placed on larger vessels and the contents were swept from the axillary vein down preserving a few intercoastal branchial nerves as well as the long thoracic and thoracodorsal. The specimen sent to pathology and the wound was irrigated with sterile water. 3 drains were placed, 1 in the axilla and 1 under each of the flaps as the patient is on blood thinners. The wound was closed......

Can I use CPT 19302 or 19307. Our NP is suggesting 19307.

Would appreciate help.

Rupa
 
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