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Ob-Gyn Coding Alert

READER QUESTIONS:

Make the Grade Coding This Wound Infection Note

Published on Wed Jun 17, 2009

Question: My ob-gyn saw a patient with a post-op wound infection following a cesarean delivery. He readmitted the patient to the hospital seven days later and did an exploratory laparotomy with extensive debridement of fascia and subcutaneous tissue. The path report says -focal necrosis.- Since it wasn't necrotizing fasciitis, I can't use 11005, can I? Should I use 11042-78? Should I also code the exploratory lap (49002-78) since they opened her up again or is this over-coding? Three days later, the patient underwent fascial closure and Filshie clip BTL. How should I code the fascial closure? Also, the ob-gyn did the Filshie clip through the abdomen since she was not closed from the previous debridement. How should this be coded? The code 58615 is vaginal or suprapubic approach. Finally, eight days later, she had primary closure. Would 13160-58 be correct? Connecticut Subscriber Answer: You can use 11005-78 (Debridement of skin, [...]
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