cclarson
Guru
Hello Everyone,
I'm not sure which code better fits this situation. Normally I'd go for a regular debridement code since that would include the irrigation, but the doctor wants to code 27301, but I'm not sure it includes the debridement? And in that case, would 27310 be worthwhile to look at? Let me know what you think. Thank you in advance!
Pathology came back with no growth aerobic or anaerobic.
Here is the report:
POSTOPERATIVE DIAGNOSIS:
Right knee infection.
OPERATION PERFORMED:
Irrigation and debridement of right knee.
Findings:
Some necrotic tissue, purulent tissue, two FiberWire sutures were removed.
DESCRIPTION OF PROCEDURE:
The patient was brought to the operating room. General anesthesia was induced. He was positioned in the supine position. Care was taken to ensure all areas were well-padded. The right lower extremity was prepped and draped using standard technique. The previous incision was used 3 cm proximal and 2 cm distal. I did ellipse around the draining sinus. We came to the patella and made a medial soft tissue dissection following a sinus tract and this was carried back to a FiberWire suture from the medial retinacular repair. Two of these removed. There was no frank pus but some necrotic tissue. We did take some cultures from around this area, debriding necrotic tissue. I did not see any evidence of necrotic bone. There was no effusion in the knee. We did not enter the joint capsule. Once we had removed the sutures and adequately debrided the area, we thoroughly irrigated and then loosely closed the incision with the exception of a small area where we had debrided the draining sinus and this was packed with a wet to dray dressing. Sterile dressing was applied. The patient was awakened and taken to the recovery room and doing well.
I'm not sure which code better fits this situation. Normally I'd go for a regular debridement code since that would include the irrigation, but the doctor wants to code 27301, but I'm not sure it includes the debridement? And in that case, would 27310 be worthwhile to look at? Let me know what you think. Thank you in advance!
Pathology came back with no growth aerobic or anaerobic.
Here is the report:
POSTOPERATIVE DIAGNOSIS:
Right knee infection.
OPERATION PERFORMED:
Irrigation and debridement of right knee.
Findings:
Some necrotic tissue, purulent tissue, two FiberWire sutures were removed.
DESCRIPTION OF PROCEDURE:
The patient was brought to the operating room. General anesthesia was induced. He was positioned in the supine position. Care was taken to ensure all areas were well-padded. The right lower extremity was prepped and draped using standard technique. The previous incision was used 3 cm proximal and 2 cm distal. I did ellipse around the draining sinus. We came to the patella and made a medial soft tissue dissection following a sinus tract and this was carried back to a FiberWire suture from the medial retinacular repair. Two of these removed. There was no frank pus but some necrotic tissue. We did take some cultures from around this area, debriding necrotic tissue. I did not see any evidence of necrotic bone. There was no effusion in the knee. We did not enter the joint capsule. Once we had removed the sutures and adequately debrided the area, we thoroughly irrigated and then loosely closed the incision with the exception of a small area where we had debrided the draining sinus and this was packed with a wet to dray dressing. Sterile dressing was applied. The patient was awakened and taken to the recovery room and doing well.