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Thread: Which codes for wound repair?

  1. #1
    Join Date
    Apr 2007
    Location
    Daytona Beach, FL
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    663

    Arrow Which codes for wound repair?

    My surgeon performed laceration repairs under anesthesia for a little girl who put her arms through a glass window. She repaired an 8cm laceration on her left forearm, which appears to be a simple repair - nothing noted about irrigation or layered closure.

    She also repaired 3 other lacerations on her right arm - One is 2cm and was jet irrigated then closed. Another was 1 cm, jet irrigated, a small ellipse of devitalized skin was excised and then closed. The 3rd was V shaped with a flap of skin which was viable, measured 10cm x 4 cm x 1cm. She states "there was 1 area where the defect went into the muscle and this was closed with 4-0 Vicryl suture. The wound was jet irrigated and closed with a combination of Insure stapling device and 4-0 chromic."

    My question is what codes would you consider these repairs? Would you code intermediate for the 2cm and 1 cm wound? Would you consider the other laceration complicated (if only mentioned that one area without measurement of muscle involvement) or intermediate - and how would you total the length of a V shaped flap - the total of all sides? I am not sure if documentation of jet irrigation is enough information to show a grossly contaminated wound for intermediate repair without mention of layered closure.

    Asked this in another forum but got no feedback and I really need to finalize this claim. Any help would be greatly appreciated!

    Thanks,
    Jodi Dibble, CPC

  2. #2
    Join Date
    Apr 2007
    Location
    Fort Myers, Florida
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    11

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    Hi Jodi, after reading this I'm not sure of what length of the "muscle area" was done so I would code a simple repair on all the procedures as a 12006 for a total of 26cm. The irrigation and excision of the small devitalized tissue would be included in the repair. T

  3. #3
    Join Date
    Apr 2007
    Location
    Fort Myers, Florida
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    Default

    Hi Jodi, after reading this I'm not sure of what length of the "muscle area" was done so I would code a simple repair on all the procedures as a 12006 for a total of 26cm. The irrigation and excision of the small devitalized tissue would be included in the repair.

  4. #4
    Join Date
    Apr 2007
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    Daytona Beach, FL
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    Thanks Jeff for you help.

    I wasn't sure about the jet irrigation as my other doctors never stated it that way. I wasn't sure if that was something that was more involved and could be considered extensive cleaning or if it was just a simple irrigation.

    Thanks again!
    Jodi Dibble, CPC

  5. #5

    Default

    You could add 11040 of you have the documentation for it....Given it's glass there may have been some debridement...you may go back and ask the doc

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