Wiki I&D of surgical wound infection (shoulder)

abaer01

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Can someone please help with this?

"Indications: Patient underwent an ORIF of her right proximal humerus fracture 3 weeks ago and presented with a superficial dehicense of the middle portion of her surgical wound with some drainage.

Name of procedure: Right shoulder surgical site infections irrigation and debridement.

Description of procedure:
There was a superficial pocket with the subcutaneous tissue adjacent to one of the distal sutures. Proximally there was a small collection of purulent fluid. The fascia was not violated and there was no drainage from or connection to the joint.

The wound was irrigated with pulse lavage and 9 L of normal saline and 1 L of puracyn. Subcutaneous tissue was reapproximated with interrupted 2-0 PDS suture. Skin was closed with a 2-0 nylon in an interrupted horizontal mattress. The skin was cleaned and dried. Shoulder was dressed...etc., etc."



The provider wants to code as 11044, and I believe a secondary wound closure code such as 13160 is appropriate, however I feel the documentation is severely lacking. Is 11044 supported by the documentation in this case? I see no debridement of bone, or at all for that matter, nor do I see measurements. My thinking is that this should be coded as 11042 with 12020 once the measurements are added to the documentation.


Thank you!!
 
Debridement is the removal of dead/necrotic tissue. The physician only rinsed the area with saline, so 110XX codes are off the table. However, the physician did asses the area (diagnostic) and see that the muscle tissue was fine and closed the skin. This would be 13160 with dehiscence diagnosis. Good news, 13160 has more RVU's, but it's also correct.
 
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