CH 22 Hemic, Lymphatic, Mediastinum, and Diaphragm

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2012 Buck Step by Step Medical Coding

The Hemic and Lymphatic Systems subsection is divided into what 3 subheadings?

Spleen, General, and Lymph Nodes and Lymphatic Channels

splenoportography

Radiographic procedure to allow visualization of splenic and portal veins of spleen

How many codes does it take to completely code a splenoportography?

2. Code the injection (Surgery) and the radiological visualization (Radiology).

allogenic

a graft/bone marrow, etc, that is from the same species, but genetically different

What are the two categories of lymphadenectomies?

Limited (removal of lymph nodes only)
Radical (removal of lymph codes and surrounding tissue)

From what section do you code a diagnostic-only laparoscopy?

Digestive System (49320)

What's another term for radical neck dissection?

complete neck dissection

Determining the grade or level of a neoplasm based on a common grading system

Staging

How many codes does it take to completely code a lymphangiogram?

2. Code the procedure (Surgery) and the radiological superivision/interpretation (Radiology)

lymphangiogram

an x-ray image of a lymph node or vessel taken after injection of a contrast medium

mediastinum

region between the lungs in the chest cavity

mediastinoscopy

endoscopic visual examination of the mediastinum

diaphragm

wall of muscle that separates the thoracic and abdominal cavities

imbrication

surgical pleating and folding of tissue to realign organs and provide extra support (eg diaphragm)

eventration

Weakening of diaphragm muscle, usually because of paralysis of the diaphragmatic (phrenic) nerve

Total or partial splenectomy codes are designated in the CPT manual as "________ procedures."

separate

You would find codes for the spleen in this subsection

Hemic and Lymphatic (Surgery)

The two categories of lymphadenectomies are:

limited/radical

True or False:The difference between the mediastinum incision codes is whether the procedure is performed with or without a biopsy.

False. Codes are organized by surgical approach.

retroperitoneal

Behind the peritoneum of the abdominal cavity

peritoneum

Membrane surrounding the organs in the abdomen

cystic hygroma

congenital deformity or benign tumor f the lymphatic system

lymphangiotomy

Incision into a lymphatic vessel

lymphangiectomy

surgical removal (excision) of a lymph vessel

What ICD9 Index term do I reference when coding the harvesting of bone marrow?

"Donor, Bone Marrow" (V59.3)

sentinel lymph node

first lymph node(s) in the lymphatic basin that receives drainage from the primary tumor in the breast; identified by a radioisotope and/blue dye

A radiologist performs lymphoscintigraphy in the radiology dept. Then the general surgeon injects blue dye and excises a sentinel lymph node (both in the operating room). What two modifiers are used?

Radiology -26 (professional component)
Surgeon -59 (Distinct procedural service) for Injection (since also excising node)

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