Wiki I&D assistance, at a complete loss!

[AR2728]

Physician performed I&D along with debridement. The Hospital is stating 28899 unlisted foot procedure for the CPT. Please review note and advise--I'm completely stuck.

Patient who is status post openreduction and internal fixation of his left foot from a Lisfranc fracture.
Patient was brought to the operating room, placed supine on the operating room table. Tourniquet was placed proximally on the left calf. The left lower extremity was then prepped and draped in a sterile manner. The foot was then elevated and tourniquet was then inflated to 300 mmHg. An incision was made on the dorsum of the left foot.
Once the skin was incised, there was a small amount of superficial purulence underneath the skin. Gram stains and cultures were then taken. Once this was done, the patient was given one gram of vancomycin. Dissection continued medially and laterally. There was no deep purulence also. At this point in time, three liters of normal saline with bacitracin was Pulsavaced on the wound irrigating it. Once this was done, the edges of the skin were debrided. 2-0 nylon suture was used to close the skin loosely. A stable soft dressing of Xeroform, 4 X 4, Webril and a short leg posterior splint was placed

 

[BCrandall]

Physician performed I&D along with debridement. The Hospital is stating 28899 unlisted foot procedure for the CPT. Please review note and advise--I'm completely stuck.

Patient who is status post openreduction and internal fixation of his left foot from a Lisfranc fracture.
Patient was brought to the operating room, placed supine on the operating room table. Tourniquet was placed proximally on the left calf. The left lower extremity was then prepped and draped in a sterile manner. The foot was then elevated and tourniquet was then inflated to 300 mmHg. An incision was made on the dorsum of the left foot.
Once the skin was incised, there was a small amount of superficial purulence underneath the skin. Gram stains and cultures were then taken. Once this was done, the patient was given one gram of vancomycin. Dissection continued medially and laterally. There was no deep purulence also. At this point in time, three liters of normal saline with bacitracin was Pulsavaced on the wound irrigating it. Once this was done, the edges of the skin were debrided. 2-0 nylon suture was used to close the skin loosely. A stable soft dressing of Xeroform, 4 X 4, Webril and a short leg posterior splint was placed

28899? Sorry, that's not right. Just because a procedure was done on the foot doesn't make it a foot procedure! Look at the debridement codes (110xx), the note doesn't say it was an excisional debridement so I'm thinking 11040 (partial thickness debridement). Is this a complication of the previous surgery? Then you can use 998.59 for the ICD-9. Hope this helps!

 

[AR2728]

Excellent! Thanks for the reply. it was indeed a complication from previous procedure.