CHAPTER 18
HEMIC, LYMPHATIC, MEDIASTINUM, AND DIAPHRAGM
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Hemic and Lymphatic Techniques Subsection (Excision, Restore, Introduction)
Divisions
Spleen
Basic
Lymph Nodes and Lymphatic Channels (Determine 18.1 in textual content)
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This subsection is split into subheadings of Spleen, Basic, and Lymph Nodes/Lymphatic Channels.
Additional division relies on kind of process, resembling excision, incision, or restore.
The place are the codes for spleen and lymph nodes situated within the CPT handbook Index? (Underneath principal phrases, spleen, lymph nodes, and bone marrow)
Spleen (38100-38200) (1 of two)
Spleen simply ruptured, causes large hemorrhage
Could require splenectomy
Splenectomy: whole or partial
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Codes for spleen are additional divided into excision, restore, laparoscopy, and introduction.
Why can an individual dwell and not using a spleen? (The bone marrow, liver, and lymph nodes take over the work of the spleen.)
Spleen (38100-38200) (2 of two)
Usually achieved as a part of extra main process
Bundled into main process
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Splenectomy carries the designation “(separate process)”; if the splenectomy is an integral a part of one other process, it’s bundled into the principle process code and isn’t reported individually.
Basic (38204-38243) (1 of two)
Codes divided based mostly on
Aspiration
Biopsy
Harvesting
Transplantation/Infusion
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What’s a bone marrow needle aspiration? What’s its code? (When a pattern of bone marrow is withdrawn by a needle from the marrow cavity, 38220)
What’s concerned in a bone marrow biopsy? What’s the code for this process? (Small items of marrow are withdrawn and the lab dissolves these in an answer. Then the substance is analyzed, 38221.)
What’s bone marrow harvesting? What’s the code for this process? (A bigger quantity of marrow is aspirated from a donor, 38230)
How is bone marrow transplanted? What’s the code for this process? (Taken from donor and injected into the recipient, 38240-38243)
Basic (38204-38243) (2 of two)
Kinds of cells:
Allogenic: Shut relative
Autologous: Affected person’s personal
Hematopoietic progenitor cells (HPC)
Bone marrow
Peripheral blood apheresis
Umbilical wire blood
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Autologous cells are collected from the affected person and reinfused later into the identical affected person.
Why would it not be advantageous to gather stem cells from a detailed relative? (As a result of there may be genetic similarity)
What are the codes for the harvesting and return of blood to the donor? (38205-38206)
Lymph Nodes and Lymphatic Channels (38300-38999) (1 of three)
Two varieties of lymphadenectomies:
Restricted: Lymph nodes solely
Radical: Lymph nodes, submandibular gland, and surrounding tissue
Time period “full” similar as radical neck dissection
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What’s the objective of the lymphatic system? (To move fluids, proteins, and fat by way of the lymphatic channels again to the blood stream)
A restricted lymphadenectomy, reported with codes 38562-38564, consists of elimination of solely the lymph nodes.
A radical lymphadenectomy, reported with codes 38700-38780, includes elimination of the lymph nodes, glands, and surrounding tissue.
Submental and submandibular nodes, chin space and under mandible
Higher jugular nodes, at mandibular angle in entrance of sternocleidomastoid muscle
Center jugular nodes, between hyoid bone and cricoid cartilage
Decrease jugular nodes, between cricoid cartilage and clavicle
Posterior triangle nodes divided into teams
Higher visceral nodes, by the hyoid bone
Superior mediastinal nodes, between frequent carotid arteries
38700, 38720—are unilateral codes
Lymph Nodes and Lymphatic Channels (38300-38999) (2 of three)
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“Modified” radical neck: elimination of all lymph nodes routinely eliminated by radical neck dissection, whereas preserving the interior jugular vein, the spinal accent nerve, and the sternocleidomastoid muscle groups (38724)
This can be a unilateral process
Lymph Nodes and Lymphatic Channels (38300-38999) (three of three)
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Lymphadenectomies
Usually bundled into extra main process (e.g., prostatectomy)
Don’t unbundle and report lymphadenectomy individually
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A restricted lymphadenectomy could also be bundled right into a extra main process; when this happens, solely the main process is reported.
What codes replicate whether or not the process was superficial or deep? (Superficial code is 38500 and deep codes are 38510-38525, and inside mammary code is 38530.)
Mediastinum (39000-39499) (1 of two)
Space between lungs
Determine 18.three
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What’s the mediastinum? (The world between the lungs)
The place does the Mediastinum and Diaphragm subsection fall within the CPT e-book? (Instantly after the cardiology subsection)
Mediastinum (39000-39499) (2 of two)
Assigned by strategy
Incision codes for overseas physique elimination or biopsy
Excision codes for elimination of cyst or tumor
Endoscopy
Restore
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The Mediastinum subheading is split by procedures and consists of incision, excision, and endoscopy classes.
Procedures are reported with use of the codes 39000-39499.
Codes are based mostly on the surgical strategy taken to carry out the mediastinotomy—both cervical (neck space) or throughout the thoracic space or sternum.
What major distinction is made within the excision codes which can be listed beneath the Mediastinum subheading? (The excision codes differ in response to whether or not a tumor or a cyst was excised.)
Diaphragm (39501-39561)
Solely class: Restore
Most codes for hernia or laceration repairs
Codes listed in CPT handbook beneath “Diaphragm”
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The place is the diaphragm situated? (The diaphragm is the wall of muscle that separates the thoracic and belly cavities.)
Only one class beneath Diaphragm subheading, Restore.
Repairs encompass lacerations and hernias.
How are the hernias of the diaphragm divided out? (Kind of hernia, age of affected person [neonate or other than neonate], and strategy [transthoracic or combined thoracoabdominal])
Conclusion CHAPTER 18
HEMIC, LYMPHATIC, MEDIASTINUM, AND DIAPHRAGM
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