bgbarrett
Contributor
Need help coding this surgery.
Attention was first turned to the right ear and an incision was marked along the anterior aspect behind the area of the tragus. The skin was then infiltrated using one-to-one mix of 1% lidocaine with epinephrine and 0.25% Marcaine plain. Next using a 15c blade an incision was made in the previously marked regions down to subcutaneous tissue, dissection then performed using tenotomy scissors. The framework was dissected off the overlying skin and a block of allogenic cartilage was then carved and the helical rim was formed. additional cartilage was carved forming the antihelix. Attention was turned back to the ear and the cavity was copiously irrigated using normal saline-containing bacitracin and gentamicin. Bleeders were then stopped using Bovie electrocautery. The framework was then inserted into the cavity over the original framework. A 10 French drain was then placed and hooked to suction, these revealed adequate contour of the ear. The antihelix was then sutured to the helical rim as well as the underlying subcutaneous tissues and Attention was then turned to the area of the conchal bowl where excess tissue was excised and passed off the table. Skin flap was then sutured down to the deep tissues as well as to the anterior aspect of incision.The incision was then closed using 4-0 Monocryl in a running fashion. The drain was then sutured in place using a 3-0 nylon. Adequate suction was verified once again and all the incisions were cleaned and bacitracin was applied to the reconstructed ear, next rolled Xeroform was placed along the triangular fossa, conchal bowl and between the helix and antihelix to accentuate the concavities and bolster was then placed over the auricle. Fluffs and a Glasscock ear cup were then applied.
I was thinking 69399, 14060 but another coder told me to use 21208. So, I am confused. Any clarification would be helpful! Thank you!!
Attention was first turned to the right ear and an incision was marked along the anterior aspect behind the area of the tragus. The skin was then infiltrated using one-to-one mix of 1% lidocaine with epinephrine and 0.25% Marcaine plain. Next using a 15c blade an incision was made in the previously marked regions down to subcutaneous tissue, dissection then performed using tenotomy scissors. The framework was dissected off the overlying skin and a block of allogenic cartilage was then carved and the helical rim was formed. additional cartilage was carved forming the antihelix. Attention was turned back to the ear and the cavity was copiously irrigated using normal saline-containing bacitracin and gentamicin. Bleeders were then stopped using Bovie electrocautery. The framework was then inserted into the cavity over the original framework. A 10 French drain was then placed and hooked to suction, these revealed adequate contour of the ear. The antihelix was then sutured to the helical rim as well as the underlying subcutaneous tissues and Attention was then turned to the area of the conchal bowl where excess tissue was excised and passed off the table. Skin flap was then sutured down to the deep tissues as well as to the anterior aspect of incision.The incision was then closed using 4-0 Monocryl in a running fashion. The drain was then sutured in place using a 3-0 nylon. Adequate suction was verified once again and all the incisions were cleaned and bacitracin was applied to the reconstructed ear, next rolled Xeroform was placed along the triangular fossa, conchal bowl and between the helix and antihelix to accentuate the concavities and bolster was then placed over the auricle. Fluffs and a Glasscock ear cup were then applied.
I was thinking 69399, 14060 but another coder told me to use 21208. So, I am confused. Any clarification would be helpful! Thank you!!