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Assign the CPT surgery code(s) and the appropriate HCPCS level II and CPT modifier(s). PREOPERATIVE DIAGNOSIS:...

Assign the CPT surgery code(s) and the appropriate HCPCS level II and CPT modifier(s).

PREOPERATIVE DIAGNOSIS: Carcinoma of the left breast

POSTOPERATIVE DIAGNOSIS: Carcinoma of the left breast

PROCEDURE: Insertion of Groshong catheter

ANESTHESIA: Local MAC

ESTIMATED BLOOD LOSS: Minimal

OPERATIVE INDICATIONS: The patient is a 55 year old female diagnosed with carcinoma of the breast. She requires a catheter for chemotherapy.

The patient was prepped and draped with the right neck and chest in operative field, in deep Trendelenburg, with a rolled sheet between the shoulder blades. One percent lidocaine was used for the skin incisions. Percutaneous access to the right subclavian was obtained with a needle, and a wire was introduced. The needle was removed, and an introducer and sheath were passed over the wire. The wire and introducer were removed. Then a Groshong 8-French catheter was introduced through the peel-away sheath and allowed to lie at the junction of the right atrium and superior vena cava. The sheath was then peeled away. A tunnel was developed in the anterior chest down to about the level of the mid breast to allow the Vitacuff and 5-0 cuff to lie subcutaneously. All of the above was done under fluoroscopic guidance with the Siemens unit. The catheter was irrigated with the heparinized saline, and it had been soaked in Chloromycetin solution prior to the event. It was sutured in place with 4-0 nylon. The patient tolerated the procedure well.

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C50.912 Malignant neoplasam of unspecified site of left female breast

CPT code is 36640 ,G9654 with 26 modifier

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