Merlin0728
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- La Crosse Wisconsin Chapter
I am looking for opinions on how to code the following surgery.
Any input would be greatly appreciated!
Postoperative diagnosis: Osteomyelitis of the forefoot right side. Wounds both dorsal and plantar, diabetic wounds.
Procedures: Resection of infected bone, fascial tissues and necrotic tissue, center right foot, around the 3rd metatarsal area and excision of both dorsal ulcer and plantar ulcer. The plantar ulcer is 3 x 3 cm. The dorsal ulcer ended up being 4.5 cm x 2 cm x full thickness all the way through the foot to the bottom.
Procedure: Full excision of the plantar ulceration was performed initially, removing all nonviable keratotic, necrotic tissues, down to healthy bleeding granulation tissue base. The dorsal ulceration was much deeper. Full excision of the ulcer was performed straight to the 3rd metatarsal bone where fragments of bone and fascial tissues were noted. These were excised. This dorsal wound probed nearly to the plantar wound and we sharply debrided all margins of the wound to healthy bleeding granulation tissue. We flushed it copiously with normal saline, 2 liters were used. We then packed the wound with 1/4 inch packing gauze and Adaptic and dry sterile dressings were applied. The patient tolerated the procedure and anesthesia well and left the operating room with all vital signs and vascular status grossly intact.
This was coded as 28122 for the dorsal ulcer and metatarsal bone that was excised and 97597 for the plantar ulcer.
Thank you!
Any input would be greatly appreciated!
Postoperative diagnosis: Osteomyelitis of the forefoot right side. Wounds both dorsal and plantar, diabetic wounds.
Procedures: Resection of infected bone, fascial tissues and necrotic tissue, center right foot, around the 3rd metatarsal area and excision of both dorsal ulcer and plantar ulcer. The plantar ulcer is 3 x 3 cm. The dorsal ulcer ended up being 4.5 cm x 2 cm x full thickness all the way through the foot to the bottom.
Procedure: Full excision of the plantar ulceration was performed initially, removing all nonviable keratotic, necrotic tissues, down to healthy bleeding granulation tissue base. The dorsal ulceration was much deeper. Full excision of the ulcer was performed straight to the 3rd metatarsal bone where fragments of bone and fascial tissues were noted. These were excised. This dorsal wound probed nearly to the plantar wound and we sharply debrided all margins of the wound to healthy bleeding granulation tissue. We flushed it copiously with normal saline, 2 liters were used. We then packed the wound with 1/4 inch packing gauze and Adaptic and dry sterile dressings were applied. The patient tolerated the procedure and anesthesia well and left the operating room with all vital signs and vascular status grossly intact.
This was coded as 28122 for the dorsal ulcer and metatarsal bone that was excised and 97597 for the plantar ulcer.
Thank you!