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Old 10-10-2012, 06:44 AM
jdibble jdibble is offline
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Arrow Which codes for wound repair?

My surgeon performed laceration repairs under anesthesia for a little girl who put her arms through a glass window. She repaired an 8cm laceration on her left forearm, which appears to be a simple repair - nothing noted about irrigation or layered closure.

She also repaired 3 other lacerations on her right arm - One is 2cm and was jet irrigated then closed. Another was 1 cm, jet irrigated, a small ellipse of devitalized skin was excised and then closed. The 3rd was V shaped with a flap of skin which was viable, measured 10cm x 4 cm x 1cm. She states "there was 1 area where the defect went into the muscle and this was closed with 4-0 Vicryl suture. The wound was jet irrigated and closed with a combination of Insure stapling device and 4-0 chromic."

My question is what codes would you consider these repairs? Would you code intermediate for the 2cm and 1 cm wound? Would you consider the other laceration complicated (if only mentioned that one area without measurement of muscle involvement) or intermediate - and how would you total the length of a V shaped flap - the total of all sides? I am not sure if documentation of jet irrigation is enough information to show a grossly contaminated wound for intermediate repair without mention of layered closure.

Asked this in another forum but got no feedback and I really need to finalize this claim. Any help would be greatly appreciated!

Thanks,
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Old 10-10-2012, 08:21 AM
NYCPC NYCPC is offline
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Hi Jodi, after reading this I'm not sure of what length of the "muscle area" was done so I would code a simple repair on all the procedures as a 12006 for a total of 26cm. The irrigation and excision of the small devitalized tissue would be included in the repair. T
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Old 10-10-2012, 08:22 AM
NYCPC NYCPC is offline
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Hi Jodi, after reading this I'm not sure of what length of the "muscle area" was done so I would code a simple repair on all the procedures as a 12006 for a total of 26cm. The irrigation and excision of the small devitalized tissue would be included in the repair.
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Old 10-10-2012, 01:19 PM
jdibble jdibble is offline
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Thanks Jeff for you help.

I wasn't sure about the jet irrigation as my other doctors never stated it that way. I wasn't sure if that was something that was more involved and could be considered extensive cleaning or if it was just a simple irrigation.

Thanks again!
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Old 10-10-2012, 05:59 PM
bill2doc bill2doc is offline
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You could add 11040 of you have the documentation for it....Given it's glass there may have been some debridement...you may go back and ask the doc
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Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

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