# Pilonidial Sinus, Surgery



## MidwestCoder (Apr 12, 2013)

Can anyone help with this?


Pre-op diagnosis: Recurrent pilonidial abscess

Post-op diagnosis:  Pilonidal sinus, recurrent.

Procedure: Wide surgical sharp excision with debridement, 3.0 x 4.0 x 4.5 centimeters.

Procedure: The patient was brought to the operating room. She was identified. A time-out was done. She was prepped and draped prior to the time out. She was on her left side with a bean bag. Pressure points were carefully padded. Local anesthesia was infultrated in the skin and deep to the external opening. An excisional sharp debridement was done after we injected Methylene Blue. The sinus tract actually was fairly limitied under the skin. The pilonidal sinus external wound, the skin the scarred granulation tissue were all sharply excised to the dimensions noted above. Marcaine 0.5% with 1:200,000 Epinephrine was infiltrated in the deep, in the perimeter and the skin and dermis of the wounds for long-term pain management. Point electrocautery was used to control hemostatis. The wound was carefully inspected. There was no evidence of residual sinus tracts, particulry on the right buttock area where the patient had been painful before. The wound was packed with Aquacel AG x 2 with several gauze sponges on top of these and ABD over this. She tolerated this well and returned to the Same Day Surgery Area.


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## kimberliterpstra (Apr 12, 2013)

I would code this with 11770.  The Coder's Desk Reference describes this CPT code: "In 11770, the physician uses a scalpel to completely excise the involved tissue.  The wound is sutured in a single layer."
I would use the diagnosis code of 685.0, pilonidal cyst with abscess.


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