1.An elderly man has a 45 ppd history of smoking & worked in a…

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Question Answered step-by-step 1.An elderly man has a 45 ppd history of smoking & worked in a… 1.      An elderly man has a 45 ppd history of smoking & worked in a factory exposed to fumes, what anatomical changes would you expect upon inspection?a.      Anteroposterior diameter increases 1-1b.      Anteroposterior diameter 2-1c.       Anteroposterior diameter 3-1d.      No changes at all Health Science Science Nursing Share QuestionEmailCopy link Comments (0)

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Question Answered step-by-step PREOPERATIVE DIAGNOSIS: Pyogenic granuloma, sinus tract, buttock.... PREOPERATIVE DIAGNOSIS: Pyogenic granuloma, sinus tract, buttock.POSTOPERATIVE DIAGNOSIS: Multiple sinus tracts, one extending inferiorly about 7 × 3 cm in diameter, one extending to the right approximately 4 × 3 cm, and one 4 × 3 cm extending to the left of 4 × 3 cm.SURGICAL FINDINGS: As above, plus (benign) granulation tissue present in a capsule of multiple sinus tracts. Sinus tracts measured a total of about 15 × 8 cm in their total dimensions.SURGICAL PROCEDURE: Partial unroofing of sinus tracts. (This is a full-thickness debridement.)ANESTHESIA: General endotracheal.DESCRIPTION OF PROCEDURE: The patient was intubated and turned in the prone position. A probe was inserted in the sinus cavity, and dissection was carried down to this. I encountered a piece of chronically infected granulation tissue coming out of a hole, in which I stuck the probe, but this continued for a distance longer than the probe and accordingly, I put my finger in this and this extended down the length of my index finger (i.e., about 7-8 cm by about 3 cm in width). I left this intact, because this would necessitate extensive dissection of 15 sq. cm. of subcutaneous tissue and we have no blood on this patient at this time. We then unroofed two other sinus cavities, and packed this opened with 2-inch vaginal packing and applied a dressing and Kerlix plus an Elastoplast. Estimated blood loss: 25 cc. The patient seemed to tolerate the procedure well and left the operating room in good condition.Coder's Query: It is unclear from the documentation exactly what the procedure was that the physician performed. The coder queried the physician and asked for additional information to ensure correct coding. The physician explained that the patient has a recurrent history of pyogenic granuloma of the buttock with sinus tracts that have, as in this instance, required a subcutaneous tissue debridement.CPT Code(s): [A], [B]ICD Code(s): [C]  Health Science Science Nursing BUSN 2375 Share QuestionEmailCopy link Comments (0)
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