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Chest Tube Revision

Date: Jun 19, 2020

Question:

Would this be coded with an unlisted code, 32999? "Initial chest radiograph demonstrated a large right-sided pneumothorax. Evaluation of the surgically placed tube demonstrated a large fibrous clot along the exit of the tube into a Heimlich valve. It appears that the Heimlich valve function was compromised due to the clot, and this may have led to the large pneumothorax. Utilizing forceps the thrombus was removed. Initially after access of the most distal aspect of the chest tube with a 16-gauge Angiocath system, the pneumothorax was evacuated by hand with 50 mL syringes followed by placement of a new Heimlich valve. This was connected to Pleur-evac suction, and CT imaging demonstrated complete evacuation of the previously seen pneumothorax. A second 0-0 silk suture was used as pursestring fashion for the exit of the chest tube in order to minimize any continued subcutaneous emphysematous change extending inward with inspiration."

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