Any help coding this would be appreciated:
Sacral skin was incised immediately experienced grayish-brown purulent drainage. Carried our dissection down using a combo of bovie electrocautery and sharp dissection to the level of the bilateral gluteal muscles. We relalized the infection extended past the current margins and the area was further debrided down to the sacrum as well as needing to resect portions of the bilateral gluteus. Turned our attention to the areas of drainage on the bilateral gluteal cleft, these areas were opened. A finger sweep was conducted that showed the subcu tissue separated easily from the underlying muscle and fascia. Due to the proximity of the rectum and the peritoneum it was decided at this point in time this area would not be extensively debrided. As much necrotic tissue as possilbe was debrided. A wound VAC was placed and the patient transferred out for further wound care management.
I'm thinking 11043 & 97605, the size is not indicated in the report.
Thank you,
Sacral skin was incised immediately experienced grayish-brown purulent drainage. Carried our dissection down using a combo of bovie electrocautery and sharp dissection to the level of the bilateral gluteal muscles. We relalized the infection extended past the current margins and the area was further debrided down to the sacrum as well as needing to resect portions of the bilateral gluteus. Turned our attention to the areas of drainage on the bilateral gluteal cleft, these areas were opened. A finger sweep was conducted that showed the subcu tissue separated easily from the underlying muscle and fascia. Due to the proximity of the rectum and the peritoneum it was decided at this point in time this area would not be extensively debrided. As much necrotic tissue as possilbe was debrided. A wound VAC was placed and the patient transferred out for further wound care management.
I'm thinking 11043 & 97605, the size is not indicated in the report.
Thank you,
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