Bianca Posted Tue 28th of June, 2016 12:38:34 PM
An upper scrotal midline incision was then made with a #15-blade scalpel followed by Bovie electrocautery and blunt dissection through the level of the scrotum. The tunica vaginalis parietal layer was dissected free around the left testicle and this was carefully delivered through the incision. There was noted to be a moderate sized hydrocele associated with the testicle and with freeing up of the upper part of the testicle, epididymis, intervention of the cord structure, this was able to be carried out to the subinguinal area whereas previous varicocele was. They were dilated vessels
specifically associated with the gubernaculum consistent with a grade II varicocele. At the upper part of the inguinal area, these appeared to be going off in a medial fashion and not part of the cord going to the external inguinal ring. Using some blunt dissection along with a small Jacobson forceps just above the epididymal area on the cord, the vas deferens was carefully identified. This was freed up circumferentially and a vessel loop was placed across this. Using an intermittent vascular Doppler, the arterial pulse of the testicular arteries were identified with some additional small veins and lymphatics were carefully dissected free with another vessel loop passed across to prevent any injury. With an additional small vascular poles consistent with arterial that was dissected along, that was not part of the vasal artery, but opposite side of the cord was freed. The remainder of the tissue was carefully identified and with vascular ultrasound consistent with venous pulses and venous flow, these were dissected and tied with 2-0 silk ties with proximal and distal control cutting in the middle. Intermittent confirmation with vascular ultrasound was done systematically to not injury any other important structures. Once all of this tissue was removed with only the two arterial pulses of vas deferens, the arterial tissue was carefully
dissected free of the other overlying venous and lymphatic tied and dissected along with confirming prior to cutting, vascular poles still present. This was just the vas deferens. The vein and the superficial tissue around the vas deferens was then carefully dissected off the vas. Again isolated, not associated with the vas, tied and cut. The hydrocele was still present and the sac was opened up and the fluid was drained.
SuperCoder Answered Wed 29th of June, 2016 09:07:30 AM
Our team is working on it and will get back soon.
Bianca Posted Fri 01st of July, 2016 11:51:04 AM
Hi, just following up on this, were you able to get an answer. Thank you
SuperCoder Answered Tue 05th of July, 2016 06:35:41 AM
The most appropriate code for above mentioned scenario is 55535.
Hope this helps!
Bianca Posted Tue 05th of July, 2016 11:03:56 AM
SuperCoder Answered Thu 07th of July, 2016 01:28:18 AM
Happy to help.