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Wiki Non-Healing Wound

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suzannekahnk@gmail.com

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Patient had a right TMA in July. Comes back to the operating room in October for wound debridement. Operative note specifically states: "Patient with non-healing surgical wound".

I submitted it to Medicare with ICD 10 code T81.89XA since this was the first time we are treating the "non-healing wound". There is a Medicare LCD for the debridement code (11044) which only allows T81.89XS. Even if I were to code as an open wound, I still can only use the S for the 7th digit per the LCD.

I thought Sequela meant, late effect. Should I be interpretting the non-healing wound as a late effect of the initial surgery instead of a complication? If that's the case wouldn't all complications be a sequela of the original procedure?

Confused between complication & sequela & A vs S 7th extension. Anyone have any advice on this??
 
Sequela is for a late effect of the condition a complication is not a late effect of the reason for the surgery. So initial treatment of the complication is coded with an A sequela of the non healing wound would be say an ugly scar formation.
 
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