Arul karthik Answered Mon 12th of September, 2011 20:26:29 PM
Can anyone help with the following op note?
1. Right T8, 9 and 10 hemilaminectomies.
2. Right T8-9 and T9-10 costal transversectomies.
3. Right T8 and 9 and T9-10 transradicular diskectomies.
Using a 10 blade the incision was opened and a
right sided subperiosteally dissection was performed exposing
the T8 to T10 levels including the transverse process and rib
junction. Having confirmed location under fluoroscopy a high
speed drill and Kerrison puncher was used to perform a right T8
to T10 hemilaminectomy and costal transversectomy. The ligament
of flavum was erimmed away and we exposed the exiting T9 nerveroot. Once the T8-9 and T9-10 disks were exposed attention was
directed to the T9-10 disks.
Using a high speed drill the superior half of the T10 pedicle
was drilled out.
Next, a 15 blade was used to perform an annulotomy and the disk
material was carefully resected until we had created a defect.
Next, a fibrotic disk fragment was noted to be knuckled towards
the thecal sac. This, was carefully dissected free and using
down biting curets was pushed into the defect that we had
created. This was retrieved using pituitary rongeurs. Once we
had c~leted the T~-l~__q;skectomy a~tention was di-rected to the
T8-9 level. In similar fashion the T9 pe~~le was drilled out.
Next, the 15 blade was used to perform an annulotomy and disk
material was pushed into this defect, wnich we confirmea-tllat we
had decompressed this level as well. Copious irrigation was
used to irrigate out the wound and ,hemostasis was achieved using
electrocautery and Surgiflow.
SuperCoder Answered Tue 13th of September, 2011 11:02:03 AM
To my opinion, the codes would be --> 63046,
+ 63048 - mod. 59
SuperCoder Answered Tue 13th of September, 2011 18:59:59 PM
Feel like this...Diskectomy:63077,63078//Laminectomy:63046-51,63048//Costal transversectomy:21610-51, 21610-59
Arul karthik Answered Tue 13th of September, 2011 19:45:49 PM
I was looking at 63064,63066 but I like your combination of codes, Try Super.