AAPC - Back to school
Results 1 to 5 of 5

Thread: need assistance coding

  1. #1
    Join Date
    Apr 2007
    Orangeburg SC

    Default need assistance coding

    AAPC: Back to School
    I have an op report that is for an abdominal washout with skin closure -- please see attached note.

    I am struggling with the code to use because the 3m coding software is leading me to an unlisted procedure

    I feel that the code is either 49000 or 49900 or even the code of 20102(but for this there was not a foreign body in the patient)

    Any assistance would be appreciated.
    __________________________________________________ ____________
    PREOPERATIVE DIAGNOSIS: Status post colostomy reversal. Status post
    bowel resection.

    POSTOPERATIVE DIAGNOSIS: Status post colostomy reversal. Status post
    bowel resection.

    PROCEDURE: Abdominal washout with skin closure.

    BRIEF HISTORY: Ms. Graham is a 61 year old African-American female
    who has recently been taken to the operating room for a perforation of
    her small bowel. She had a small bowel resection and fascia closure
    of her abdominal skin was open. She is being taken to the operating
    room for washout of her skin.

    DESCRIPTION OF PROCEDURE: The patient was taken back to the operating
    theater and placed on the operative table in the supine position.
    Upon proper identification at the time of the procedure, the patient
    was sedated, prepped and draped in a sterile fashion. We then
    irrigated one liter of normal saline of the subcutaneous tissue. We
    then reapproximated the skin with the staple. In the inferior portion
    of the incision, I did reapproximate the subcutaneous tissue with
    interrupted 2-0 Vicryl suture. We then reapproximated the skin with
    skin gun. All counts were correct. The patient was transferred to
    PACU in stable condition.

  2. #2
    Join Date
    Apr 2007
    Swainsboro/Statesboro, GA

    Default Probably need to discuss with the physician

    Hello Jalbright0516,

    This procedure notes seems to be confusing, as the diagnosis doesn't seem to match the procedure name, and the procedure name doesn't seem to match the procedure description!

    It reads like a wound dehiscence but I would not code it as such without the physician agreeing to this and providing an addedum to the existing report.

    I do not agree with the codes of 49000 nor 20102 as the report does not support either code.

    Good luck!
    Freda Brinson, CPC, CPC-H, CEMC
    2014 President AAPC Swainsboro, GA Chapter
    Past President - 2012, 2008; Past Vice President - 2013, Past Education Officer - 2009 of Savannah, GA Chapter
    Past Member AAPCCA Board of Directors (2009-2012)

  3. #3
    Join Date
    Apr 2007
    Chicopee, MA


    Looks like a 12020 to me.


  4. #4
    Join Date
    Apr 2007
    Bangor, Maine


    I agree with Erika on the 12020. I have the 3M software as well and it does sometimes lead you to the wrong codes. I usually trust it with my Dx codes (because I know a lot of them by heart), but I ALWAYS double check my CPT book for my procedure codes. Actually, I usually start with the book and then go into 3M. It may sound old school but it has always worked for me.

  5. #5
    Join Date
    Apr 2007
    Columbia, MO


    Try using keywords of seconday wound closure or postoperative wound closure. This should take you to the 12020 code in 3M. This looks like a planned postoperative wound closure but that wouls still be the correct code, your ICD-9 will be the dx for delayed closure. This is common following a bowel perforation due to the possiblity of infection.

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. Need assistance in coding this please.....
    By Cuteyr in forum Interventional Radiology
    Replies: 2
    Last Post: 06-19-2015, 08:30 AM
  2. Coding assistance
    By CODING1234 in forum OB/GYN
    Replies: 1
    Last Post: 06-27-2014, 06:04 AM
  3. coding assistance
    By tmitchell in forum Cardiology
    Replies: 0
    Last Post: 09-26-2013, 02:23 PM
  4. Electronic Coding Assistance
    By chortenz in forum General Discussion
    Replies: 6
    Last Post: 06-27-2011, 11:37 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.