# Delayed closure help!



## mindyanna (Apr 15, 2011)

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!


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## twosmek (Apr 15, 2011)

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.


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## PLAIDMAN (Apr 15, 2011)

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.


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## mindyanna (Apr 18, 2011)

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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