Question

Case 4 Preoperative and postoperative diagnosis Painful enlarging right vulvar eyst Operation performed: Excision of right vulvar cyst Reason for surgery: This 34-year-old female patient has a vulvar cyst that is causing pain and discomfort The patient was taken to the OR and placed in the supine position. IV analgesis was started, and then she has placed in the dorsal lithotomy position. The surgical site was prepared with Lidocaine 1%, and then epinephrine and bicarb was administered. A 20- mm cyst was seen on the medial right upper labia minor A S blade was used to make a 1.2.cm incision, freeing the cyst. The cyst was removed. The area was closed with 5-0 Vicryl running interrupted sutures. The patient tolerated the procedure. She was placed back in the supine position and transferred to the recovery room in satisfactory condition CPT Code Case 5 Preoperative and postoperative diagnosis: Laxity of skin and muscle of the abdomen Procedure: Abdominoplasty The 46-year-old female patient desired to have an abdominoplasty because of the laxskin, subcutaneous tissue, and muscle of her abdomen. The risks of the procedure were explained to the patient. and she signed the consent to have the procedure When the patient presented to the operatory area, the midline of the abdomen was marked for the planned incisions. The abdomen was prepped, and 45 ce of a local infiltration of 196 Lidocaine with 11000000 dilution of epinephrine was administered along the planned incisional lines Askin incision was made along the marking, which was carried through the skin and subcutaneous tissue and Bovie clectrocautery Dissection of the tissue was completed down to the facial musculature of the abdomen. Aperiumbical incision was made, and the umbilical stalk was freely dissected. Additional dissection Occurred, and a moderate amount of redundant skin was assessed. Using a 15 blade and Bovie clectrocautery, a superior incision was made. The tissue along the upper incision was thinned, and, with hemostasis achieved, the site was irrigated with aline. Above and below the umbilicus, aplication of the rectus muscle was performed with the patient in the semiflexed position, several tacking 2-0 Vicryl sutures were placed. An incision was then made at the iliac crest bilaterally using a 15 blade. Using Bovie electrocautery, the periumbilical area was defutted, 3-0 Vicryl sutures were used to close. On both sides, drains were placed and suured in place. Closure was completed and additional 3.0 Vicryl sutures and subcuticular 4-0 Vicryl sutures. 3.0 and 4-0 Vicryl sutures, followed by 5-0 nylon sutures, were used to close the periumbical area. The wound was dressed. There was approximately 55 cc of blood loss. After extubating the patient, she was transferred to the recovery area in stable condition GULIA

Answer 1

Vulva is the area present at the external genital organs. The most common cyst formed in the vulva area is termed as vulvar cyst. Pus normally collected over the affected area. The current procedural terminology code for the operative procedure removal of the right vulvar cyst is 11422 excision of benign lesion,genitalia of diameter over 4.0 cm. In the given scenario the lesion or cyst excised is of diameter 20 mm (2.0 cm).

Abdominoplasty is categorized under cosmetic surgery that focuses on removing excess of skin from the abdominal region. It is also termed as tummy tuck surgery. The most common indications of abdominoplasty includes increased abdominal wall laxity , high BMI. The different types of abdominoplasty includes complete , partial , FAB technique. The CPT code for abdominoplasty is 15830 excision,excessive skin and subcutaneous tissue(includes lipectomy).