avon4117
Guru
okay this patient had burr hole evac about 9 months now she presents for a wound break down.
Under loupe magnification,, 0.5 lidocaine with epinephrine was injected in the subcu skin and the scalp, then a 10 blade scalpel was used to free the scalp from the underlying skull, old bone wax materials were removed. Cultures were obtained superficially and then deep in the epidural space. NO evidence of gross infection noted. After the dura was scraped and clean, wound was irrigated copiously.
Gelfoam and thrombin was placed over the dura, which was bacteriostatic, then new bone wax was was placed and vancomycin powder was placed actually deep to the bone wax and superficial bone wax as well. The edges of the scalp wound was pruned back sharply with sharp debridement until there was some bleeding. sutures were used to close the galea and a 2-0 prolene suture in a running locking stitch was also used to close the scalp loosely. Triple antibiotic ointment was applied, following sterile dressing and benzoin and then the pt was extubated and brought to recovery in good condition.
I was leaning toward cpt code 12020 but it seems to undervalue what the physician did. Any code suggestions?
Under loupe magnification,, 0.5 lidocaine with epinephrine was injected in the subcu skin and the scalp, then a 10 blade scalpel was used to free the scalp from the underlying skull, old bone wax materials were removed. Cultures were obtained superficially and then deep in the epidural space. NO evidence of gross infection noted. After the dura was scraped and clean, wound was irrigated copiously.
Gelfoam and thrombin was placed over the dura, which was bacteriostatic, then new bone wax was was placed and vancomycin powder was placed actually deep to the bone wax and superficial bone wax as well. The edges of the scalp wound was pruned back sharply with sharp debridement until there was some bleeding. sutures were used to close the galea and a 2-0 prolene suture in a running locking stitch was also used to close the scalp loosely. Triple antibiotic ointment was applied, following sterile dressing and benzoin and then the pt was extubated and brought to recovery in good condition.
I was leaning toward cpt code 12020 but it seems to undervalue what the physician did. Any code suggestions?