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Thread: Delayed closure help!

  1. #1
    Join Date
    Apr 2007
    Charm City

    Default Delayed closure help!

    AAPC: Back to School
    I have a podiatrist who is doing a delayed primary closure of a foot ulceration and an akle ulceration. I am not sure what codes to use for these. The op note reads as follows:

    "The foot ulceration medially was then debrided with a sharp 15 blade, rongeur, curet and then a delayed primary closure was performed after pulse lavage with 3 liters normal sterile saline with #1 PDS suture without difficulty" and the ankle one states:

    "A right lateral ankle ulceration was debrided with a sharp 15 blade, rongeur and curet and pluse lavage with 3 liters of normal sterile saline and closed with #1 PDS suture in a palm-sole stitch fashion without difficulty."

    He also puts a wound VAC and debrided a right ankle wound posterior. Also closed with #1 PDS suture proximally but the distal aspect of the posterior ankle ulceration was then wound VAC'd closed with 125 mmHg continuous without difficulty

    I am not sure what a #1 PDS suture is. Is this a simple, intermediate or a complex type of closure?

    Can anyone help direct me to the correct set of codes to use for this procedure?

    Thank you!

  2. #2
    Join Date
    Apr 2007
    Duluth, MN


    You need to use the V58.41 icd-9 code for planned post op wound closure and then you would use the CPT code 13160 secondary closure of surgical wound or dehiscence extensive or complicated. I would think anyway.
    Tina Wosmek CPC, COSC

  3. #3
    Join Date
    Apr 2007


    The repair (closure) codes are based on how many layers had to be closed, muscle, subcutaneous tissue , skin, etc.....

    The cpt gives definitions of each type at the beginning of your repair code set.(my book does)

    Your physician should be dictating how many layers were closed IF it was a layered closure. If it was not a layered closure - then it was simple.

  4. #4
    Join Date
    Apr 2007
    Charm City


    Thank you for your responses. I appreciate you taking the time to help me out! I will speak to the physician sometime today to get some clarification as to whether this was a layered closure or simple.

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