Hip infection 26992?

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Hello helpful coders, the surgeon did an I&D for a hip infection and wants to use 26992 which is for infection of bone. I have read the op note several times and he did not document cutting to bone. Should the correct code be the 26990 or could I use the 27030 arthrotomy with hip drainage since he did put in a drain. Thanks again for your input. I just wanted to have someone to run this by. Paula

INDICATIONS
The patient is a 61-year-old who sustained a right hip fracture
approximately 2 weeks ago, underwent hemiarthroplasty. She was
discharged from here doing fine. She was at the nursing facility and
had increased drainage and was brought to the hospital for evaluation.
She was admitted and set up for surgery.
PROCEDURE
The patient was identified in preop holding both verbally and by her
identification tag, transferred to the op suite, placed on the OR table
in the supine position. Anesthesia addressed the patient, gave general
anesthetic, secured an airway. The patient was placed in the lateral
decubitus position on a bean bag. The right side was towards the
ceiling. All bony prominences were well-padded. An axillary roll was
placed. She was secured. Right lower extremity was prepped, draped in
sterile fashion after the staples were removed. The patient's incision
had erythema and some drainage. Dissection was carried down through the
skin. The skin edges were ellipticized, and suture was removed, the
Vicryl suture. She had a large hematoma and serous fluid. She had no
gross pus. The tensor fascia lata was intact. The Vicryl sutures were
removed from this, and there was hematoma in the joint. There was no
frank pus. She underwent irrigation and debridement. The skin edges,
subcutaneous tissue, fat, deep tissue was debrided. All the infectious
tissue and tissue that appeared questionable was removed. Neurovascular
structures were gently protected. The Ethibond and Vicryl sutures were
removed that were placed from prior surgery. After thorough
debridement, she was irrigated with pulse lavage with 12 liters of
normal saline. The middle 2 had bacitracin. After thorough lavage, the
tissue seemed appropriate. The hip was stable. The deep fascia was
tissue and tissue that appeared questionable was removed. Neurovascular
structures were gently protected. The Ethibond and Vicryl sutures were
removed that were placed from prior surgery. After thorough
debridement, she was irrigated with pulse lavage with 12 liters of
normal saline. The middle 2 had bacitracin. After thorough lavage, the
tissue seemed appropriate. The hip was stable. The deep fascia was
closed with 0 PDS, 2-0 PDS closed subcu, and #2 nylon suture with a
vertical mattress stitch closed the skin. Sterile dressing was placed.
She had a drain placed deep into the hip prior to closure and was
transferred to PACU. She will be admitted for IV antimicrobial
treatment for cultures, and ID will be consulted. Will treat her with
Arixtra 2.5 mg for DVT prophylaxis and discontinue the Lovenox treatment
and continue SCDs. Will progress her with therapy and follow her wound
and hip..
 
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