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Eva Posted 1 Year(s) ago
The patient was placed in supine position on the operating table with electrocardiographic and blood pressure monitoring and general anesthesia was induced. A double lumen endotracheal tube was inserted with the aid of a flexible bronchoscope. The patient was then placed in a semi-left decubitus by placing a bump in the back. A submammary incision was then performed, measuring approximately 5 mm in length. The fascia and subcutaneous tissue were entered with electrocautery obtaining hemostasis simultaneously. The pleural cavity was entered and it took a while to remove all the blood clots, but we knew that there was some active arterial bleeding since the blood was bright red and kept on accumulating in the area. Finally,we made a separate skin incision through which we placed a port and through that the 5-mm thoracoscope. The bleeder finally was identified in an area of the tumor at the eighth rib. The suture transfixion initially did not work. The second pass with pledgeted sutures, this time we obtained hemostasis. The cavity was dried off. The port was removed and a chest tube was inserted through it. A right-angled size 32 was anchored to the skin with heavy silk and connected to a Pleur-Evac. Intercostal nerve cryolysis was performed at the level of the incision, one level above and one level below. The fascia and subcutaneous tissue were approximated with 2-0 Vicryl and the skin with 4-0 Vicryl subcuticular. The patient tolerated procedure well and was reintubated with a single-lumen tube and transferred to the Intensive Care Unit in critical but stable condition. I believe this service is beyond 32551 but I'm not sure which code to use to report the active bleeding repair in the tumor area.
SuperCoder Posted 1 Year(s) ago

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Please find answer in the post below.



Eva Posted 1 Year(s) ago
This answer is unclear, I asked what cpt would be appropriate to code for this scenario. I attached the operative report and your response was if documentation supports this. How would you have come up with the answer without interpreting my attached report?
SuperCoder Posted 1 Year(s) ago



Since the repair of bleeder was done via thoracoscopy, you may report code 32654 (Thoracoscopy, surgical; with control of traumatic hemorrhage). The code suggested by you (i.e. 32551) has CCI edit with 32654. So you should not report 32551 along with 32654.



Posted by Eva, 1 Year(s). There are 4 posts. The latest reply is from SuperCoder.

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