NS coders-please help-crani wound debridement

srpaul

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Can anyone tell me if the following can be coded 61514/78? Pt had craniotomy for sdh removal x 2 one month ago through the same frontotemporal bone flap. Wound dehisced spontaneously with spontaneous flow of purulence from the subcutaneous space. Bone flap had come loose at two of anchoring sites as well as purulence in the epidural space. Bone flap was removed and dura debrided. there was significant quantities of necrotic tissue, both subgaleal and muscle all which was removed with blunt and sharp dissection. all sutures removed and meticulous hemostasis obtained. Bone flap was not replaced.
TIA-Shelly
 
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penguins11

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It doesnt look like he is decompressing again, he is removing because of an infection. I would look at the cranioplasty codes, in particular, 62142.
 
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