Forum - Questions & Answers

Dec 6th, 2013 - marigold 2 

repost-WHICH DRAINAGE CODE?

Hi, Guys,
For report below, there are two procedures...
first, an aspiration
second - placement of a drainage cath.
two sites
QUESTION For 2nd procedure... What is best code for percutaneous drainage? All of them say I&D...when that is not what was done. the puncture abscess code does not apply, as we placed a catheter. Book directs one to use 10060/61/10140/20005. All of these codes are for an I&D

CLINICAL HISTORY: 4-year-old female patient with history of left
neck abscess, here for ultrasound guided drainage.


PROCEDURE:
Limited ultrasound examination of the left aspect of the neck
demonstrated a small fluid collection in the carotid space at the
level of carotid bifurcation, measuring approximately about 1.1
cm in maximum diameter, compatible with abscess. This is
corresponding to the fluid collection seen on CT examination.
Superior and lateral to this collection there is a solid
appearing lesion measuring approximately 1.5 cm in maximum
diameter, without internal fluid collection probably representing
inflammatory phlegmon. Multiple lymphadenopathy are noted in the
left aspect of the neck, without evidence of suppuration.

The skin of the neck was prepped and draped in sterile fashion.
Using real-time ultrasound guidance a 21 gauge needle was
inserted into the necrotic appearing abscess collection.
Approximately 2 mL of purulent material was aspirated and sent to
lab for culture and sensitivity.

Then attention was drawn to what appears to be inflammatory
phlegmon which was much superior. Under ultrasound guidance a
21-gauge needle was inserted into the lesion. Aspiration yielded
no pus. A 014 guidewire was inserted into the lesion and coiled.
The tract was dilated with 4, 5, and 6 F dilators and. Then a 6
French Dawson Mueller catheter was advanced over the wire and the
distal loop was formed within the lesion under ultrasound
guidance. The catheter was sutured to the skin with 3-0 prolene
and secured with a stat-lock device. A JP bulb was attached to
the catheter. A sterile occlusive dressing was applied.

There were no complications and the patient left the IR suite in
stable condition. Dr. was present for the entire
procedure.

FINDINGS: Limited ultrasound examination of the left aspect of
the neck demonstrated a small fluid collection within



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