Wiki Wedge Resection

[Monika Liddle]

Hello,

We have a physican who is performing a thorascopic lung procedure. During the procedure he is not able to locate the nodule/lesion and extends the incision to insert his hand to locate the nodule/lesion before performing a wedge resection. The thorascope is still inserted, would you code this procedure as a thorascopic or open procedure.

Thank you for your help.

Monika

 

[LindaEV]

How did he end up taking the resection? If the thoracoscopy was involved, I would not code as open.
Look for signs that the scope was used primarily...or was it just to "take a look" during/after an procedure open.

Linda

 

[Monika Liddle]

Linda,

The physician indicates he spreads the ribs apart with his hands and then resects the nodule/tumor using the thorascope as a visual aid. He indicates he does not use the thorascope with any instrumentation once he extends the incision and places his hand inside.

Monika

 

[NaliniAAPC]

Hi,

AS per documentation, he does not use the thorascopy, he extended the incision site and place his hand...i think there is no scope involved?

Regards,
Nalini CPC