A posterolateral thoracotomy incision was made and the fifth intercostal space was entered. One rib was shingled. we spent some time getting the adhesions down, which was kind of surprising seeing that the did have a pneumo, however, we did free up the lung and found what appears to be a weaker part of the lung, almost looks like it was abrased. This was biopsied and sent to pathology. Doxy was used as a chemical pleurodesis. A bovie pad was used to aggressively scratch the inside surface of the chest as a mechanical pleurodesis. once chest tubes were placed in the apex of the thorax, vicryl sutures were used to close the remaining layers. After the incision was completely closed we then directed our attention to the pretty large wound where the chest tube had been inserted. This chest tube had been taken out previously. we used a curet to truly clean this out. Asmall incision was about at least 4 inches wide and 4-5 inches deep. We did clean this out and curetted down to good bleeding tissue. There were no signs of pus. a wound vac was placed without complications.
I show the open thoracotomy with biopsy codes are 32096 – 32098. The Pleurodesis code is 32650 showing mechanical or chemical. I am not sure at all where to go with the wound from the chest tube I was looking in the 11000 codes and I show the wound vac placement as 97605. I may be way off base on all of these codes but I was doing my best before asking for help. This is the first time I used this, I hope I did it correctly.
Thank you