Revision of empyema cavity with chest irrigation and replacement of wound VAC

rgrimes

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I have a difficult scenario and am hoping for some guidance on codes:

1) Patient originally had lobectomy, then returned for air leak and returned to the OR for the following: Redo right posterolateral thoracotomy, repair of dehisced bronchial stump. Repair of right lower lobe lung parenchyma.

2) A week or so later, patient was returned to the OR for the following: Completion pneumonectomy through redo posterolateral thoracotomy. Decortication of empyema. Four-rib thoracoplasty. Wound VAC placement on the right chest cavity.

3) Patient came back to the OR 3 times for Wound VAC change and irrigation of right chest cavity. No debridement mentioned for these visits. I don't know what code to use for chest irrigation and replacement of wound VAC. 97605 doesn't seem like enough. It seems that they have left the wound open are irrigating and packing it every other day in the OR.

Thank you for any help you can give on this

Ruth Ann
 
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