# Help Abdominal Washout



## CRC CPC (Jan 22, 2010)

For some reason my brain is not working correctly today please help.  One of my General Surgeons did following:
Pt was taken to op room, abdomen was prepped and draped in usual manner.  The previous drain was removed.  The tract was explored down to midline incision.  A seroma Cavity was noted.  This was anterior to the mesh.  The mesh had healed nicely.  It was not visible.  This is subcutaneous fat area Seroma.  Pt is morbidly obese.  The cavity was entered and washed with betadine and saline.  There was no other purulence encountered... wound was packed with Iodoform adn the skin was approximated w/staples.  
Am I missing something?  I cant find any irrigating or washing in regards to the abdomen.  Any help would be appreciated.
Thanks,
CRC CPC


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## CRC CPC (Jan 22, 2010)

What about 49080?  Please give me some feed back....


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## BLOWRIE (Apr 13, 2010)

*abdominal washout*

I don't know if we have the same situation, but I will tell you how we code for reopening of an abdominal wound with wash out.  If a patient had a surgery that required the abdomen be left open and a vac pac or temporary closure was used, we code 49002 for the reopening and washout.  We have many patients, who unfortunately have to have their abdominal wounds left open following a major surgery and may have to have the vac pac removed in several planned returns to the OR for the washout and re-application of the vac pac.  We have asked about using this code in several coding seminars and coding lectures and so far no one has told us to code this situation any differently. We us the modifier 58 to indicate these reopenings and wash outs were planned procedures.  The codes you asked about are really more percutaneous, where a needle is used to insert fluids and then withdraw the fluids to wash out the abdominal area.  Hope this helps in some way.


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