Wiki I&D w/ sharp debridement of abscess of abd wall

ksb0211

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Hoping to settle a debate on coding this one. Opinions appreciated! :-D

POSTOPERATIVE DIAGNOSIS
Abscess of abdominal wall.

PROCEDURE/OPERATION
Incision and drainage with sharp debridement of abscess of abdominal wall.

DESCRIPTION OF PROCEDURE
The patient was taken to the O.R. after induction of adequate anesthesia. The patient was prepped with DuraPrep and draped sterilely.

The skin was incised in the left lower quadrant over the apex of her pannus. The somewhat foul smelling, gray brown purulent material exuded. The necrotic overlying skin was sharply debrided as was underlying necrotic tissue. Multiple tracts and tunnels were opened. An additional small pocket was appreciated just above this. The wound was then thoroughly irrigated with antibiotic solution. Hemostasis was used with electrocautery. The wound was injected with 1/4% Marcaine with epinephrine and then packed with antibiotic-soaked gauze.
 
I think the problem here is lack of documentation. 11005 would be nice if "underlying necrotic tissue" was elaborated to, subcutaneous tissue, fascia in which they probably did going into the abdominal wall..otherwise look at second choice 10180 if post op wound

Otherwise defaut to debridment codes 11042>>>

MS
 
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