26608 and wound closure

coder21

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Can you code 26608 with 13131? Or should it be 12045?


Operative note: On 07/14/2017 patient was seen in the emergency department taken back to the operating room to the preoperative area where the operative extremity was identified and marked. Subsequently the patient was taken back to the operating room where she remained on the hospital stretcher. She is placed under general anesthesia with as anesthesiologist of record. Patient was prepped and draped in normal sterile fashion. Timeout was performed. Ancef had been confirmed that had been given. Tetanus had been confirmed that she was up-to-date on her booster. Tourniquet was inflated to 200 mmHg. The wound was copiously irrigated. The thumb was then percutaneously pinned and the fracture was fixed with 2 Kirschner wires 1.6 mm. The wound was then re-irrigated with copious irrigation. The subcutaneous fat was draped over the superficial branch of the radial nerve that was completely exposed. I was able to examine the extensor tendons that did not demonstrate any sign of laceration but were completely exposed. The subcutaneous fat was sewn in place with 4-0 PDS suture. The skin was then closed with staples to allow for swelling and drainage. The thumb was then cleaned and subcutaneous injection of half percent Marcaine was then injected into the soft tissue. Xeroform 4 x 4 Kerlix Ortho-Glass Ace wrap splint were then put in place. Patient was transferred to the PACU without complication after activation.
 

iowagirl77

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The repair codes bundle to the fracture repair. From your note, it doesn't appear to be a separate site so I don't think you can bill the intermediate or complex repair in addition to the fracture repair. I hope that helps!

Susan
 
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