# Removal and exchange of Abthera wound vac



## maine4me (Nov 7, 2012)

Can someone please help me with this operative report?  The surgeon removed the old vac and placed a new one, I told him the codes from the manufacturer were 97605 and 97606 depending on the size of the wound, he said he did more surgery and wants to bill using  49002.  I just don't see anything other than the wound care therapy.  

PREOPERATIVE DIAGNOSIS:  Multiple abdominal abscesses status post placement of Abthera
wound VAC. 

POSTOPERATIVE DIAGNOSIS: Same. 

PROCEDURE: Removal and exchange of Abthera wound VAC and irrigation of abdominal cavity. 

ANESTHESIA: General 

PROCEDURE AND FINDINGS:  The patient was brought to the Operating Room and properly
identified and placed on the table in the supine position. Preop diagnosis, procedure and
site were confirmed on time out. She was already on IV antibiotics. General anesthesia
was induced via IV and orotracheal tube. The external portion of the wound VAC was
removed along with the foam portion in the subcutaneous tissues. The abdomen and wound
was then prepped with Betadine and drapes applied. The Abthera wound VAC was then removed
from the abdominal cavity. Manual probing was done and any potential adhesions or
loculations easily accessible were broken up. The abdomen was then irrigated and
suctioned with some suction. A new Abthera wound VAC was then tailored to approximately
the same for proportion as the original one. It was placed into the abdominal cavity and
straightened out so that it lay as flat as possible. Next the other foam pieces were cut
to the appropriate size to fill in the gap in the muscle and subcutaneous tissue until it
was slightly above the level of the skin. The occlusive sheet was then applied in layers
to the entire abdominal wall and the wound VAC. Vacuum tubing was then applied and
secured in place for an airtight seal and then the system was attached to the wound VAC
and it maintained a very good seal. She tolerated the procedure well and was reversed and
extubated and left the Operating Room in stable condition, breathing on her own to
recover in the PACU.


----------



## syllingk (Nov 8, 2012)

Both those codes state they include Removing devitalized/necrotic tissue and promoting healing. I don't see anywhere in that note that they reopened the laparotomy.


----------

