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Resection of Vagus Nerve

Date: Nov 25, 2014

Question:

Need assistance with coding an excision of paranganglioma of the vagus nerve. I'm thinking 64771, but possibly needs to be an unlisted procedure. Procedure: A transverse incision was made from the midline laterally approximately 2 fingerbreadths above the clavicle. Dissection was deepened. The platysma was divided and platysmal flaps were raised. Dissection was deepened and jugular vein was dissected along it's medial edge and retracted laterally. The paranganglioma was identified and it was clearly not only adjacent to, but part of the vagus nerve. We carefully dissected this trying to ascertain whether or not the paranganglioma could be resected and the vagus nerve preserved, however, it was apparent that the lesion was actually part of the nerve itself. For this reason, we resected the paranganglioma with a section of vagus nerve proximally and distally. Pathology was obtained and sent for exam. Careful inspection for any other areas of neoplasm was carried out and none were seen. Closing began.

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