amanda19791
Networker
Need some advice.
Should a 58 modifier be applied for a replacement of the second silo performed on the same day? See op notes.
1st placement of silo(49605):
Weighing 1.3 kg, the patient is significantly small making reduction of the abdominal contents untenable. The abdominal wall defect is quite small, and I struggled to get a 4 cm silo placed. Given the narrow nature of a 4 cm silo, and force of the bowel higher above the patient. After placement of the silo, the pink and viable bowel began to mildly darkened and look dusky. The decision was made to give the patient short amount of time to see if the bowel perfusion could adjust, otherwise, opening of the abdominal defect and replacement of the larger silo would be indicated
2nd placement of silo(49605):
Bowel was dusky and with emerging ischemia, tight in the silo. Approximately 1 cm opening on the right side of the abdominal defect allowed for replacement of the 4 cm dilated with a 5 cm silo. Bowel noticeably improved in perfusion.
Should a 58 modifier be applied for a replacement of the second silo performed on the same day? See op notes.
1st placement of silo(49605):
Weighing 1.3 kg, the patient is significantly small making reduction of the abdominal contents untenable. The abdominal wall defect is quite small, and I struggled to get a 4 cm silo placed. Given the narrow nature of a 4 cm silo, and force of the bowel higher above the patient. After placement of the silo, the pink and viable bowel began to mildly darkened and look dusky. The decision was made to give the patient short amount of time to see if the bowel perfusion could adjust, otherwise, opening of the abdominal defect and replacement of the larger silo would be indicated
2nd placement of silo(49605):
Bowel was dusky and with emerging ischemia, tight in the silo. Approximately 1 cm opening on the right side of the abdominal defect allowed for replacement of the 4 cm dilated with a 5 cm silo. Bowel noticeably improved in perfusion.