Help please with debridement of traumatic wound

Ccgerson

Networker
Messages
69
Location
Phoenixville, PA
Best answers
0
I was going to code 11010, however only "skin" is documented as being debrided. The "vessel loops" have me stumped. Not sure if I can code this as secondary closure. ??

DIAGNOSIS:*
Preoperative Diagnosis: Left grade 3 open distal femur fracture status post multiple I and D's with ex-fix converted to retrograde IM nail
Postoperative Diagnosis: Left grade 3 open distal femur fracture status post multiple I and D's with ex-fix converted to retrograde IM nail
*
PROCEDURE:*
Operation performed: Irrigation and debridement left thigh with replacement of wound VAC and placement of 2 Hemovacs.


The anterior and lateral wounds were inspected and those with the has since had all nylon sutures removed. Digital inspection of the wounds revealed purulence at each location. The Vesseloops from the medial wound were removed and there was a small amount of purulence from this area as well. The muscle all appeared viable as did the skin edges with the exception of a small portion of the anterior wound described above. This was removed sharply. 4 L of saline solution with bacitracin were flushed through the wounds in total. A vessel loop lateral was reconstructed on the medial wound with approximately 50% closure compared to the prior size. There was proximally 2 cm of gap remaining at the conclusion of this procedure. A sterile silver wound VAC dressing was placed over this medial wound. The anterior and lateral wounds were partially closed over a Hemovac at each location.
 
Top