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Thread: dx help...

  1. #1
    Join Date
    Apr 2007

    Default dx help...

    AAPC: Back to School
    chronic sinus tract on buttock??

    this dx was dictated in the note - on the superbill he wrote this dx out and checked off 998.83 for nonhealing surgical wound. I cant find anything for the chronic sinus tract and am hesitant to use the 998.83 since it isnt mentioned in the dictation. Can anyone help me with this one?

    Thanks so much!!!
    Mary Beth Gord, CPC

  2. #2
    Join Date
    Apr 2007
    Louisville, KY


    Try looking at 685---pilondial cyst codes.
    685.0---with abscess
    685.1---without mention of abscess

    The definition for this is:
    A pilonidal cyst commonly involves an abscess or chronic draining sinus, usually at the base of the spine. It develops when a dead hair or hairs are pushed into the skin forming a canal or passage.

    On your 998.83---non healing surgical wound.

    A non-healing surgical wound is one of the complications other than infection that delays healing, or it maybe a wound that is not progressing despite appropriate treatment. Refer to WOCN guidelines (wocn.org) to check the definition of "not healing" or "non-healing".

    Hope this helps....
    Anthony Bush, CPC
    Coding Compliance Analyst

    "Learn to Love your work and you will never have to work again."

  3. #3
    Join Date
    Apr 2007
    Kokomo, IN

    Default sinus tract

    Try 686.9 unspecified local infection of skin and subcutaneous tissue. (fistula of skin NOS and skin infection NOS)

    If you check in ICD-9 under sinus then go to tract it tells you to go to fistula. The fistula then asks where it's located. This would be on the skin, so unfortunately you get a generic code. See if this works for you.

  4. #4
    Join Date
    Apr 2007
    New Orleans, LA

    Default 998.6?

    The skin fistula works if you don't feel comfortable mentioning the post-op status.

    Persistent postoperative fistula is 998.6. By using the post op code on the superbill (supplementary documentation), the physician is indicating this is what it is. Depending on the description of the wound in the report, you might be able to reasonably deduce that this was the site of a prior procedure.

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