ishtiyaq.ahmad
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Hi,
I have doubt on the below scenario for leg area:
Surgeon did surgical debridement of necrotic tissue, full thickness down to tendon and retinaculum, found the sinus tract, opened this up, minimal exudate noted. We curetted the bone corresponding to the x-ray findings in the
sinus tract and sent for bone biopsy, culture and sensitivity along with soft tissue culture and sensitivity. Deep repair with 1 Vicryl Xmattress suture, then the fenestrated Oasis was grafted in place and the edges of the wounds were revised. We then placed a Sentrex over the top of this soaked in vancomycin and tobramycin and did partial advancement closure with #1 Vicryl X-mattress suture, reducing the original wound down to 1/3 size. After completion there, we debrided the other two areas, the heel was healed. There was a slit 4 mm x 1 x 1, plantar lateral of the fifth metatarsal head. We put the rest of the Sentrex Ultra over this, a bulk sterile dressing to below the knee with Ace wraps and go back in the Aircast.
I have confusion whether we can code 15275 along with 14040 because as per documentation "did partial advancement closure with#1 Vicryl X-mattress suture"or we should not consider it as ATT. Because in ATT guideline its mentioned that if any secondary defect needs skin graft closure we can code separately. As per documentation here they are using Skin substitute graft along with partial advancement closure. So can we code 15275 for graft and 14040 for partial advancement closure which is reducing the original wound down to 1/3 size.
Please suggest.
I have doubt on the below scenario for leg area:
Surgeon did surgical debridement of necrotic tissue, full thickness down to tendon and retinaculum, found the sinus tract, opened this up, minimal exudate noted. We curetted the bone corresponding to the x-ray findings in the
sinus tract and sent for bone biopsy, culture and sensitivity along with soft tissue culture and sensitivity. Deep repair with 1 Vicryl Xmattress suture, then the fenestrated Oasis was grafted in place and the edges of the wounds were revised. We then placed a Sentrex over the top of this soaked in vancomycin and tobramycin and did partial advancement closure with #1 Vicryl X-mattress suture, reducing the original wound down to 1/3 size. After completion there, we debrided the other two areas, the heel was healed. There was a slit 4 mm x 1 x 1, plantar lateral of the fifth metatarsal head. We put the rest of the Sentrex Ultra over this, a bulk sterile dressing to below the knee with Ace wraps and go back in the Aircast.
I have confusion whether we can code 15275 along with 14040 because as per documentation "did partial advancement closure with#1 Vicryl X-mattress suture"or we should not consider it as ATT. Because in ATT guideline its mentioned that if any secondary defect needs skin graft closure we can code separately. As per documentation here they are using Skin substitute graft along with partial advancement closure. So can we code 15275 for graft and 14040 for partial advancement closure which is reducing the original wound down to 1/3 size.
Please suggest.