Liz2013
Contributor
PREOPERATIVE DIAGNOSIS: Right testicular torsion.
POSTOPERATIVE DIAGNOSIS: Right testicular torsion.
PROCEDURE PERFORMED:
1. Scrotal exploration.
2. Reduction of right testicular torsion.
3. Bilateral orchiopexy.
4. Bilateral excision of appendix testis.
5. Left hydrocelectomy.
6. Bilateral cord block.
ANESTHESIA: General endotracheal anesthesia.
INDICATIONS FOR PROCEDURE: This is a 25-year-old gentleman, who was seen in the emergency room after approximately 11 hours of right-sided testicular
pain. Ultrasound confirmed decreased flow, suspicious for torsion. The patient was emergently brought to the operating room for exploration.
DESCRIPTION OF PROCEDURE: The patient was brought to the operating room, placed under general endotracheal anesthesia, and prepped and draped in the
standard sterile fashion. Preoperative antibiotics were given. There was obvious lateral lie of the right testicle. A median raphe incision was
made. We dissected into the right hemiscrotum, delivered the testicle, opened up the tunica vaginalis. The testicle was inherently purple and there was a 360-degree twist of the cord. This was untwisted and the testicle was placed in a warm saline gauze. While this was revascularizing to check for viability, we entered the left
hemiscrotum and delivered the left testicle. There was a hydrocele around the left testicle. This was opened and the tunica vaginalis was plicated behind the cord in a
Lord procedure fashion with Vicryl suture. At this time, using Mersilene suture, the testicle was pexy'ed to the scrotum in three distinct places and using half-percent
Marcaine, a cord block was performed. Prior to doing this, the appendix testis was excised and passed off the field as specimen. We then inspected the right testicle, which had become more pink. The appendix testis was engorged in blood and this was removed and sent off as specimen. The decision was made to try to save the testicle. The testicle was fixated in three distinct places with Mersilene suture. The dartos muscle was recreated on both sides with Vicryl suture. Prior to doing this, using half-percent Marcaine, a cord block was performed on the right side. The skin was reapproximated with chromic suture and sterile dressing was applied.
The patient was awakened and brought to the recovery room in stable fashion
I think the scrotal exploration, bilateral excision of appendix testis and cord block are inclusive. My thinking of coding this is as followed: 54600-RT, 54600-LT and 55040-LT. If someone can please advise if you agree or disagree with these codes. Thank you
POSTOPERATIVE DIAGNOSIS: Right testicular torsion.
PROCEDURE PERFORMED:
1. Scrotal exploration.
2. Reduction of right testicular torsion.
3. Bilateral orchiopexy.
4. Bilateral excision of appendix testis.
5. Left hydrocelectomy.
6. Bilateral cord block.
ANESTHESIA: General endotracheal anesthesia.
INDICATIONS FOR PROCEDURE: This is a 25-year-old gentleman, who was seen in the emergency room after approximately 11 hours of right-sided testicular
pain. Ultrasound confirmed decreased flow, suspicious for torsion. The patient was emergently brought to the operating room for exploration.
DESCRIPTION OF PROCEDURE: The patient was brought to the operating room, placed under general endotracheal anesthesia, and prepped and draped in the
standard sterile fashion. Preoperative antibiotics were given. There was obvious lateral lie of the right testicle. A median raphe incision was
made. We dissected into the right hemiscrotum, delivered the testicle, opened up the tunica vaginalis. The testicle was inherently purple and there was a 360-degree twist of the cord. This was untwisted and the testicle was placed in a warm saline gauze. While this was revascularizing to check for viability, we entered the left
hemiscrotum and delivered the left testicle. There was a hydrocele around the left testicle. This was opened and the tunica vaginalis was plicated behind the cord in a
Lord procedure fashion with Vicryl suture. At this time, using Mersilene suture, the testicle was pexy'ed to the scrotum in three distinct places and using half-percent
Marcaine, a cord block was performed. Prior to doing this, the appendix testis was excised and passed off the field as specimen. We then inspected the right testicle, which had become more pink. The appendix testis was engorged in blood and this was removed and sent off as specimen. The decision was made to try to save the testicle. The testicle was fixated in three distinct places with Mersilene suture. The dartos muscle was recreated on both sides with Vicryl suture. Prior to doing this, using half-percent Marcaine, a cord block was performed on the right side. The skin was reapproximated with chromic suture and sterile dressing was applied.
The patient was awakened and brought to the recovery room in stable fashion
I think the scrotal exploration, bilateral excision of appendix testis and cord block are inclusive. My thinking of coding this is as followed: 54600-RT, 54600-LT and 55040-LT. If someone can please advise if you agree or disagree with these codes. Thank you