Preoperative Diagnosis: Right scaphoid fracture Type of Proc…
Preoperative Diagnosis: Right scaphoid fracture Type of Procedure: Open reduction and internal fixation of right scaphoid fracture. Description of Procedure: The patient was brought to the operating room, anesthesia having been administered. The right upper extremity was prepped and draped in a sterile manner. The limb was elevated, exsanguinated, and a pneumatic arm tourniquet was applied. An incision was made over the dorsal radial aspect of the right wrist. Skin flaps were elevated. Cutaneous nerve branches were identified and very gently retracted. The interval between the second and third dorsal compartment tendons was identified and entered. The respective tendons were retracted. A dorsal capsulotomy incision was made, and the fracture was visualized. There did not appear to be any type of significant defect at the fracture site. A 0.045 Kirschner wire was then used as a guidewire, extending from the proximal pole of the scaphoid distal ward. The guidewire was positioned appropriately and then measured. A 25-mm Acutrak drill bit was drilled to 25 mm. A 22.5 mm screw was selected and inserted and rigid internal fixation was accomplished in this fashion. This was visualized under the OEC imaging device in multiple projections. The wound was irrigated and closed in layers. Sterile dressings were then applied. The patient tolerated the procedure well and left the operating room in stable condition. What CPT code is reported for this procedure?
Read DetailsThe patient was brought to the suite. After oral sedation,…
The patient was brought to the suite. After oral sedation, the scrotum was prepped and draped. 1% lidocaine was used for local anesthesia. The vas was identified, skin was incised, and no scalpel instruments were used to dissect out the vas. A segment about 3cm in length was dissected out. It was clipped proximally and distally, and then the ends were cauterized after excising the segment. Minimal bleeding was encountered and the scrotal skin was closed with 3-0 chromic. The identical procedure was performed on the contralateral side. The patient tolerated the procedure well. He was discharged from the surgical center in good condition with Tylenol with Codeine for pain.
Read DetailsA 79 year old male with symptomatic bradycardia and syncope…
A 79 year old male with symptomatic bradycardia and syncope is taken to the Operating Suite where an insertion of a DDD pacemaker will be performed. After the anesthesiologist provided moderate sedation, the cardiologist performed a left subclavian venipuncture. A guide wire was passed through the needle, and the needle was withdrawn. A second subclavian venipuncture was performed, a second guide wire was passed and the second needle was withdrawn. An oblique incision in the deltopectoral area incorporating the wire exit sites. A subcutaneous pocket was created with the cautery on the pectoralis fascia. An introducer dilator was passed over the first wire and the wire and dilator were withdrawn. A ventricular lead was passed through the introducer, and the introducer was broken away in the routine fashion. A second introducer dilator was passed over the second guide wire and the wire and dilator were withdrawn. An atrial lead was passed through the introducer and the introducer was broken away in the routine fashion. Each of the leads were sutured down to the chest wall with two 2-0 silk sutures each, connected the leads to the generator, curled the leads, and the generator was placed in the pocket. We assured hemostasis. We assured good position with the fluoroscopy. What CPT code(s) is (are) reported by the cardiologist?
Read DetailsAn incision was made in the mid-palm area, between the thena…
An incision was made in the mid-palm area, between the thenar and hypothenar eminence. Meticulous hemostatis of any bleeders was performed, and the fat was identified. The palmar aponeurosis was identified, cut and traced down to the wrist. Severe compression of the median nerve was observed, and additional removal of the aponeurosis was performed to allow for further decompression. After this was completed, the area was irrigated with saline and bacitracin solution and closed as a single layer using Prolene 4-0 as interrupted vertical mattress stitches. Dressing was applied, and the patient was brought to the recovery.
Read DetailsA dialysis patient presents in the radiology department. Hi…
A dialysis patient presents in the radiology department. His physician suspects that the tip of Hickman’s catheter in his left forearm may have migrated from its original placement. The vascular surgeon on-call injects radiopaque iodine into the patient’s port and examines it under fluoroscopic imagining.
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