0TBB8ZZ Excision of Bladder, Via Natural or Artificial Opening Endoscopic

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 0TBB8ZZ Excision of Bladder, Via Natural or Artificial Opening Endoscopic 


Transurethral procedures are minimally invasive surgical procedures performed through the urethra to treat various conditions affecting the urinary system, including the bladder, urethra, and prostate gland. These procedures involve the use of a cystoscope, a long, thin tube with a light and camera at the end, to visualize the inside of the urinary tract and perform surgical interventions.

Scenario 


Pre-procedure diagnosis:

Bladder cancer

Post-procedure diagnosis:

same as pre-procedure dx


Procedures performed:
Cystoscopy clot evacuation and TURBT-transurethral section of bladder tumor

Procedure Note:

Patient was taken to the operating room and placed in supine position. General anesthesia was administered, and antibiotics were given. A time-out was performed. The patient was placed in lithotomy and prepped and draped in a sterile surgical fashion. All pressure points were appropriately padded.


The procedure began by placing a 21 French rigid cystoscope per urethra into the bladder under direct vision. A Toomey syringe was utilized to evacuate extensive amounts of clot in the bladder, approximately 500 mL, with necrotic pieces of bladder tumor identified as well. A transurethral resectoscope was then placed, and the surgeon began to resect with a monopolar loop friable bladder tumor that was necrotic and bleeding. The fragments were irrigated out, and the base of the tumor was fulgurated. The patient had a large bladder tumor burden remaining. He tolerated the procedure well, and bleeding was controlled with fulguration. A 22 French 3-way catheter was placed, and continuous bladder irrigation started. The patient was awakened from anesthesia and suffered no apparent event.


ICD-10 CM and PCS Codes:


Pre-Procedure Diagnosis: C679 Malignant neoplasm of bladder, unspecified

Post-Procedure Diagnosis: C679 Malignant neoplasm of bladder, unspecified, and D62 Acute posthemorrhagic anemia


Principal Procedure: 0TBB8ZZ Excision of Bladder, Via Natural or Artificial Opening Endoscopic

Secondary Procedure: 0TCB8ZZ Extirpation of Matter from Bladder, Via Natural or Artificial Opening Endoscopic


MS-DRG v40.0: 669 - Transurethral procedures with CC

APR-DRG v40.0: 446 - Urethral and transurethral procedures


Conclusion:

In conclusion, transurethral procedures are minimally invasive surgical interventions that are commonly used to treat various conditions affecting the urinary system. The procedure performed on the patient in this case was an Excision of Bladder, Via Natural or Artificial Opening Endoscopic (0TBB8ZZ) with a secondary procedure of Extirpation of Matter from Bladder, Via Natural or Artificial Opening Endoscopic (0TCB8ZZ). This procedure was successful in removing the bladder tumor burden and controlling postoperative bleeding.

The estimated bill for this procedure was $11,116, and the patient was diagnosed with malignant neoplasm of the bladder, unspecified, and acute posthemorrhagic anemia. .







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