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Incision and drainage of multiple abscesses

bill2doc

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Looking at 10061 but how do I capture all that happen here with each site. Thanks so much in advance everyone !


patient was placed in a modified right lateral decubitus position. The initial mass was noted and felt on CT to be a cyst over the left anterior hip was examined with ultrasound. Once the mass was identified, a needle was inserted and frank pus was aspirated. The left gluteal abscess was identified in a similar manner. The left side was then prepped and draped in standard fashion. A longitudinal incision was then made and overlying the left lateral using a left anterior hip collection was carried through the subcutaneous tissues and down to the muscle and there is no gross abscess noted in these tissues, penetration deeper but was beneath the muscle and noted a small abscess cavity from which gray foul-smelling purulent material was obtained. Palpation of the cavity noted that it appeared to track down to the bone. The left gluteus was also incised in a longitudinal manner. This incision was carried through the subcutaneous tissues beneath the muscle to the noted abscess cavity which again was very deep and appeared to go down again to the bone. Purulent drainage was obtained from this. The cavity appeared to go at least 10-12 cm from the surface of the skin. These 2 wounds were then irrigated with pulse lavage. The left hip wound was then packed using 1 inch Nu Gauze and then 4 x 4s. The gluteal wound was packed with Kerlix and then moist for 4 x 4s. These were covered by ABD pads. The patient was then rotated again into the supine position and rotated more towards a left lateral decubitus and beside the right gluteal collection was again identified using a combination of ultrasound and aspiration. The tissue was then incised overlying and again, this appeared to be quite deep fluid collection beneath the muscle. Cavity was again evacuated and irrigated with pulse lavage and this was approximately 15 cm deep. Again, close to the bone. This wound was packed using a 1 inch Nugauze. A small bleeding arteriole was noted during the packing and this was oversewn using a 3-0 suture ligature. Dressings were then applied.
 

bill2doc

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Messages
389
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Hmm just took a look, I'm concerned about the notes "subcutaneous tissues and down to and beneath the muscle" Do you think 20005 captures all ?? Seems that I have several locations. Was looking at 10160 for hip note (a needle was inserted and frank pus was aspirated) just not sure about the others that seem to go deeper into the tissue...
 
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