# dx help...



## mgord (Feb 11, 2009)

chronic sinus tract on buttock??

this dx was dictated in the note - on the superbill he wrote this dx out and checked off 998.83 for nonhealing surgical wound. I cant find anything for the chronic sinus tract and am hesitant to use the 998.83 since it isnt mentioned in the dictation. Can anyone help me with this one?

Thanks so much!!!


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## AnthonyBush (Feb 11, 2009)

Try looking at 685---pilondial cyst codes.
685.0---with abscess
685.1---without mention of abscess

The definition for this is:
A pilonidal cyst commonly involves an abscess or chronic draining sinus, usually at the base of the spine.  It develops when a dead hair or hairs are pushed into the skin forming a canal or passage.

On your 998.83---non healing surgical wound.

A non-healing surgical wound is one of the complications other than infection that delays healing, or it maybe a wound that is not progressing despite appropriate treatment.  Refer to WOCN guidelines (wocn.org) to check  the definition of "not healing" or "non-healing".

Hope this helps....


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## Anna Weaver (Feb 11, 2009)

*sinus tract*

Try 686.9 unspecified local infection of skin and subcutaneous tissue. (fistula of skin NOS and skin infection NOS)

If you check in ICD-9 under sinus then go to tract it tells you to go to fistula. The fistula then asks where it's located. This would be on the skin, so unfortunately you get a generic code. See if this works for you.


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## whaleheadking (Feb 11, 2009)

*998.6?*

The skin fistula works if you don't feel comfortable mentioning the post-op status.  

Persistent postoperative fistula is 998.6.  By using the post op code on the superbill (supplementary documentation), the physician is indicating this is what it is. Depending on the description of the wound in the report, you might be able to reasonably deduce that this was the site of a prior procedure.


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