I need the CPT, ICD 10, and HCPS code please
17-17
LOCATION: Outpatient, Hospital
PATIENT: Hank Thomas
SURGEON: Ira Avila, M.D
PREOPERATIVE DIAGNOSIS: Urinary incontinence.
POSTOPERATIVE DIAGNOSIS: Same.
PROCEDURE PERFORMED: Insertion of double cuff artificial urinary sphincter with 25 cc reservoir.
HISTORY: This patient is having radiation for prostate cancer. He then had cryotherapy. His PSA is undetectable but he has significant urinary incontinence unresponsive to pharmacotherapy. External clamp devices have been unsatisfactory.
DESCRIPTION OF PROCEDURE: The patient was given a spinal anesthetic, prepped and draped in a supine position. A penoscrotal incision was made. A 16 French Foley was placed in the bladder to straight drainage. The urethra was dissected to the level of the bulb. The bulbocavernous muscle was very atrophic and was not dissected off the urethra. A double cuff placement was selected. The urethra was mobilized in two places with a small bridge of tissue between them. These cuffs were incised. Both were incised at 4.5 cm. A reservoir space was created by manual dissection in the left inguinal canal into the retropubic space. The reservoir was placed, cycled, and filled with 25 cc of sterile saline. Both cuffs were placed in the usual fashion. The pump was then placed in the mid-scrotal pouch. Connections were made using a Y connector and straight connectors in the usual fashion. The system was cycled; it worked well. Foley catheter was withdrawn to insure cycling appropriately. Subcutaneous tissues were closed with 3-0 chromic and skin with a 4-0 subcuticular Vicryl stitch. The pump was cycled again and then deactivated; the Foley catheter replaced. The patient tolerated the procedure well and was transferred to the recovery room in good condition. The wounds were thoroughly irrigated with Bacitracin solution.
