Diagnosing and treating medical coding pericardial conditions require a variety of procedures. Cardiac tamponade, characterized by fluid accumulation that affects heart function, is treated with pericardiocentesis (33016). A needle inserted through the skin drains fluid from the sac during this procedure. One of the purposes of the procedure is for hypotension due to extrinsic compression of the heart chambers to be corrected in a patient with cardiac tamponade.
Another procedure that you may have to code while medical coding pericardial procedures is a tube pericardiostomy (33017) is used for specimen collection, culture, or drainage. Depending on the patient's condition, the drainage tube may be removed after a few days.
In cases where blood clots or foreign bodies need to be removed, a pericardiotomy (33020) may be required. Depending on the case, subxiphoid surgery, right anterior thoracostomy, sternal splitting, or thoracoscopic surgery may be used.
A thoracoscopy is when a doctor examines the chest cavity outside the lungs. Thoracoscopes are thin, flexible tubes with a light and tiny camera at the end. Small incisions are made between the ribs near the lower ends of the shoulder blades to insert the tubes. Thoracoscopic surgery can be performed for pericardial tissue collection, biopsy, irrigation, drainage, or cultures. The code 32658 removes blood clots or foreign bodies from the intrapericardium via thoracoscopy.
A pericardiectomy removes the fibrous sac surrounding the heart, called the pericardium. Constrictive heart disease complicated by adhesive pericarditis requires this procedure. Cardiopulmonary bypass (CPB) may be used during some pericardial procedures, which carries risks. Hypothermia, cardiac standstill, and oxygenators are used in such cases. It simulates the heart's function by oxygenating blood, removing CO2, and returning it to the body. Cardiopulmonary bypass determines the code selection.
For resection of a pericardial cyst or tumor see 33050.
Medical Terminology Simplified
Pericardiocentesis- Aspiration of the pericardium
Pericardiotomy- Incision in the pericardium
Pericardiostomy- Tube inserted in the incision in the pericardium
Pericardectomy- Excison of the pericardium
Cardiopulmonary bypass- A heart-lung machine that takes over for the heart and lungs during surgery
Cardiac tamponade- occurs when excess fluid accumulates in the pericardial sac and compresses the heart, leading to decreased cardiac output and shock.
Thoracoscopy- is a minimally invasive procedure that consists of a doctor using a scope to look inside the chest