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Post-operative wound

  1. Question Post-operative wound
    Medical Coding Books
    I am looking for some advice on how to code this inpatient surgical procedure.

    Patient has had previous incision and drainage procedures (22010). This is another return to the OR.

    From operative report: Previous wound vac is removed. The wound looked very good with red edges and no signs of dehiscences in the level below. We irrigated the wound with antibiotic irrigation. All the wound edges (superficial) were freshened. Given the amount of gaping of the wound (approx 6cm), we determined that we would need to place a wound vac for a longer period of time. We put a narrow sponge into the wound itself and then placed a new smaller wound vac. Next week we will look at doing the primary closure.

    Would 11042 & 97605 be appropriate for the documentation above?

    Thank you in advance for the assistance.

  2. #2
    Location
    Greater Pittsburgh
    Posts
    390
    Default
    Please look @ the note under CPT code 11042 that reads for debridement of skin (epidermis and/or dermis only), see 97597, 97598. You state in your note, all the wound edges superficial were freshened-6cm. I would suggest 97597-58 and the vac is included. The 11042 is for debridemnet subcutaneous tissue.
    jdemar, CPC, CMA

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