Staged partial abdominal wound closures


Gig Harbor, WA
Best answers
I would like your input on how to code this procedure:
Our patient has had a previous abdominal surgery with Permacol mesh placed. Due to small bowel distention and edema, the abdominal wound would not close. A few days after the initial surgery, he underwent a staged partial abdominal closure described as:
The Permacol mesh was incised in the midline nearly its entire length. The ProTak stapler was used to reinforce the fascial attachments circumferentially. The Permacol was then reapproximated with running #2 nylon overlapping approximately 1 cm on both sides. A wound VAC was placed.
Four days later, this procedure was repeated for tightening of the closure: The suture in the middle of the Permacol mesh was removed and the small bowel gently dissected free from the deep side of the Permacol with blunt dissection. Approx. 1 cm was trimmed from the Permacol and the remaining mesh was reapproximated with running Prolene suture. A new wound VAC dressing was placed.

Suggestions? I am thinking of CPT 13160-58, but am not sure if this addresses a staged procedure or simply the final wound closure...