Problem:
Patient rotated to 90 degrees, the Mclvor oral retractor was then placed within the oral cavity suspended via the Mayo stand. Initially, the uvula was retracted superiorly, which revealed mild to moderate obstructive adenoidal hypertrophy. Adenoidectomy was then performed utilizing a small size curette. Approximately 1 tonsillar sponge was then placed within the posterior nasopharynx and left there for proximately 5 minutes. During this time, the tonsils were tentative. Upon physical examination, tonsils were +3 to 4 with definitely occluding the oropharyngeal airspace. Initially, the right tonsil was then grasped at the superior pole of the curved Allis and using electrocautery the right tonsil was dissected down access of the inferior pole. Hemostasis was easily obtained using suction cautery. Following this the left tonsil was then grasped with the superior pole of the curved Allis and again using electrocautery, the left tonsil was dissected down excess of the inferior pole. Hemostasis was easily obtained using suction cautery. The tonsillar sponge was removed from the posterior nasopharynx. The oral cavity and nasopharynx were irrigated with copious amounts of normal saline, which revealed no active hemorrhage or gross complications. The patient was sent to the recovery room in satisfactory condition and will be admitted for 23-hour observation for airway management with most probable discharge in the a.m. What is the ICD-10-PCS coding? Need Assignment Help?