lmwilhoite
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Would I be able to bill a office visit during the post op period with this information:
Her abdomen is soft, nontender, nondistended. Bowel sounds are present. Her midline wound is intact except for the most inferior 2 cm where there is a small amount of thin yellow drainage. Her staples were removed and the inferior portion was opened revealing a small cavity. This was swabbed and sent for culture. The wound was then packed with 1/2" Iodoform tape and covered with a dry gauze.
and
Her abdomen is soft, obese, nontender to palpation. Her midline wound is intact except for a 1 cm opening in the lower aspect. This is lined with clean moist granulation tissue approximately 5 cm in depth.
The wound was packed with 1/4" Iodoform tape and covered with a dry gauze.
Her abdomen is soft, nontender, nondistended. Bowel sounds are present. Her midline wound is intact except for the most inferior 2 cm where there is a small amount of thin yellow drainage. Her staples were removed and the inferior portion was opened revealing a small cavity. This was swabbed and sent for culture. The wound was then packed with 1/2" Iodoform tape and covered with a dry gauze.
and
Her abdomen is soft, obese, nontender to palpation. Her midline wound is intact except for a 1 cm opening in the lower aspect. This is lined with clean moist granulation tissue approximately 5 cm in depth.
The wound was packed with 1/4" Iodoform tape and covered with a dry gauze.