Wiki Complicated wound vs Without Complication

[ksue]

Having a dilema here on outpt wound care visits.
HPI notes: medial and lateral ankle wound secondary to several possibilities including i believe venous insufficiency. I believe there is a component of distal arterial disease. She has been on hydroxyurea for treatment of polycythemia vera and I think certainly these wounds could be related to the hydroxyurea.
Impression: lateral malleolus wound, which was very tiny last time has gotten larger and is more painful than the original wound. she poorly tolerated compression wrap. Dr. XX will assess her venous and arterial flow. Algisite with medihoney both wound beds, surepress compression wrap daily.

Wound procedure notes: Open wound/selective debridement.

Would you code as DX 891.0 for uncomplicated wound and 238.4 for polycythemia vera. With CPT 97597 (per LCD DX for an uncomplicated wound does not meet Medical Necessity for the debridement).
Am I on the right track here?
Since no mention of delayed healing I am assuming we can't just use a complicated wound code correct?

Thank you in advance!!

 

[deborahcook4040]

Per my favorite wound care article (found here: http://www.fortherecordmag.com/archives/040912p28.shtml )"The fourth-digit subcategory may identify whether the wound is complicated. A complicated open wound includes mention of delayed healing, delayed treatment, foreign body retention, or infection. There is no strict definition of delayed healing or treatment. If a patient delays seeking treatment by one week, for example, and the wound does not seem to be healing appropriately, then the complicated code should be used. If the coder is unsure, query the physician. The delayed treatment and healing tends to lead to infections, which then qualifies as a complicated open wound."

I'd code it as complicated.