Answered step by step
Verified Expert Solution
Link Copied!

Question

1 Approved Answer

List the correct ICD 10 principal procedure code and significant procedure code from case study attached below. Chapter 13 1. PREOPERATIVE DIAGNOSES: Pulmonary nodule, left

List the correct ICD 10 principal procedure code and significant procedure code from case study attached below.

image text in transcribed
Chapter 13 1. PREOPERATIVE DIAGNOSES: Pulmonary nodule, left lower lobe, and metastatic adenocarcinoma of the colon POSTOPERATIVE DIAGNOSES: Pulmonary nodule, left lower lobe, and metastatic adenocarcinoma of the colon OPERATIVE PROCEDURE: Left thoracotomy with wide resection of the left lower lobe, and left upper lobe with mediastinal lymphadenectomy CLINICAL HISTORY: This 52-year-old male with known metastatic colon carcinoma status post colon resection and subsequent liver resection, status post chemotherapy, underwent CT scan of the chest, which revealed a 1.5-cm non-calcified avid pulmonary nodule of the superior segment of the left lower lobe. Additionally, there was an 8-mm nodule of the left upper lobe. Left thoracotomy for resection was indicated. The procedure, benefits, and risks of the operation were explained to the patient, and he agreed to the planned surgery. OPERATIVE TECHNIQUE: After adequate general anesthesia was established using a double- lumen endotracheal tube, the patient was positioned in the right lateral decubitus position, and the left chest region was prepped with DuraPrep and draped in the usual fashion. A universal timeout was conducted and confirmed as correct. An incision was made over the lateral aspect of the left chest. A muscle-sparing incision was performed. Latissimus dorsi was retracted posteriorly, and the serratus anterior was divided in the course of its fibers. Thoracotomy was performed in the fifth intercostal space. The lung was deflated and examined. A 1.5-cm to 2-cm nodule was present in the superior segment of the left lower lobe. A nodule was present in the posterior segment of the left upper lobe and measuring about 8 cm in diameter. A 4-cm nodule was present in the lingula. The left lower lobe nodule was addressed first. The adjacent lung tissue was grasped with Duval clamps, and using the Endo GIA 4.8-cm staple device, wide resection of this nodule was performed. The nodule was sent to Pathology for analysis. Frozen section analysis revealed this nodule to be adenocarcinoma favoring metastatic colon cancer. Next, the 8-cm nodule of the posterior segment of the left upper lobe was grasped with a Duval clamp, and wide resection was performed using Endo GIA 4.8-cm staple device. Similarly, the nodule measuring about 4 cm in the lingula, which appeared grossly to possibly be an intraparenchymal lymph node was delivered and the adjacent tissue grasped with a Duval clamp. This nodule was resected by removing the tip of the lingula using Endo GIA 4.8- cm staple device. The upper lobe and lingular nodules were sent for pathology. Next, the mediastinum was examined. Lymph nodes were present in the region of the aortopulmonary window. The overlying pleura was incised, and the entire chain of nodes was dissected, measuring about 8 cm in diameter. Hemostasis was completed by the use of hemoclips and Bovie cautery. The nodes were removed and sent to Pathology for permanent section while labeled L4. The areas of dissection were examined. Hemostasis was completed. The left lung was inflated under saline, and no significant air leak was present. The left pleural space was then irrigated with antibiotic solution and CoSeal coagulants were applied to the parenchymal staple lines. One #36 chest tube was placed in the left pleural space. The ribs were approximated with #2 and #5 Tevdek sutures in figure-of-eight pericostals. The remainder of the wound was closed in layers with Vicryl suture and reinforced with skin tapes. Sterile dressings were then applied. The operation was terminated. At this point, the patient was transported to postanesthesia recovery room in stable condition following extubation

Step by Step Solution

There are 3 Steps involved in it

Step: 1

blur-text-image

Get Instant Access to Expert-Tailored Solutions

See step-by-step solutions with expert insights and AI powered tools for academic success

Step: 2

blur-text-image

Step: 3

blur-text-image

Ace Your Homework with AI

Get the answers you need in no time with our AI-driven, step-by-step assistance

Get Started

Recommended Textbook for

Trusts Law

Authors: Charlie Webb, Tim Akkouh

5th Edition

113760672X, 978-1137606723

More Books

Students also viewed these Law questions

Question

What community placements are available for practica?

Answered: 1 week ago