excision, transplantation, transposition, or what?

[incandescens]

Work continues busy. Today's high point was trying to work out the proper coding for a case of nipple transplant.

(The patient in question had had some skin excised from his neck - I assume it was a he, for reasons that will become apparent -- and had required a skin/muscle graft (pectoralis minor) from his chest to go on the excision area on his neck. This skin graft had included one of the nipples. The patient was now requesting that the nipple be removed from his neck and put back on his chest. The question was, how was the excision and resiting of the nipple to be coded?)

(They're not always that interesting.)

(And yes, I did make references to witch-burning, extra nipples, and so on.)

Another coworker has been invited to a christening in October, and has requested that I make a quilt for her. This is rather cool. (Though probably like buses, with a long wait and then three coming along at once.)

---

What can you find at Watchmaker's Hill?

A sinister fungal wilderness by the river. The Department of Menace Eradication subcontracts the adventurous to deal with the things that slither out of Bugsby's Marshes. An observatory atop the hill employs only blind men.

-- Echo Bazaar

Comments

[flemmings.livejournal.com]

Didn't anybody notice that the graft included a nipple? How could one not notice something like that?

[incandescens]

I think it may be the case that they had to take a particular piece of skin/muscle, and unfortunately there was no way to get a large enough piece to fit the area-to-be-grafted without taking the nipple as well.

I don't know, though. We only have the basic documentation, and of course it's been redacted to remove all the patient-sensitive data as well. (We have to send a lot of queries back due to insufficient information.)

[archangelbeth]

I'm rather shocked that they didn't automatically have a follow-up scheduled X months down the line, to have the nipple put back in the correct spot. O_O

[incandescens]

It's possible that something was planned, but that they acted earlier than scheduled at the patient's request. Again, they haven't included much information.

[archangelbeth]

Ahhh. That is more reassuring.

[incandescens]

They have to leave out any patient-relevant information because of confidentiality, so we often end up missing large chunks of background in the operation notes. Sometimes this is relevant, sometimes not. In this case, one would like to think that there were further details outside the basic medical/clinical facts, but since they were patient-confidential . . .

[archangelbeth]

True, true! Still... alarming without some of the details!

[incandescens]

Oh, definitely!