HELP! I AM TRYING TO CODE AND IRRIGATION AND DEBRIDEMENT OF POST WOUNDS/AMPUTATION. THE WOUND CARE CODES WILL NOT WORK BC PTS ARE UNDER ANESTHESIA. I HAVE RUN INTO TO 2 OF THESE CASES. WOULD CPT CODE 11004 WORK??
HERE IS A SCRUBBED VERSION OF WHAT I AM CODING:
PT who has had a debridement and attempted wound closure in the past. Due to his continued drainage and wound problems, irrigation and debridement and possible further proximal osteotomy of the metatarsals in order to get the wound closed.
i began extensively debriding the necrotic and gangrenous tissue on the right forefoot. then subperiosteally exposed the trans metatarsals and took this back with a rongeur, far enough to where I had viable and healthy bone and bleeding tissue. This was essentially almost to the level of the tarsal metatarsal joint area. After I debrided sufficient tissue, I then worked on three additional wounds that were just on the periphery to the main wound. This was debrided extensively. I then washed 6000 cc of Gentamicin impregnated saline. This was all done after deep wound cultures were obtained.
I then was able to perform a wound closure using 2-0 Nylon suture in a vertical mattress fashion, closing all wounds except for the three peripheral wounds. A sterile saline dressing was applied to these wounds and a compressive dressing was applied to the remaining forefoot.
any suggestions????
HERE IS A SCRUBBED VERSION OF WHAT I AM CODING:
PT who has had a debridement and attempted wound closure in the past. Due to his continued drainage and wound problems, irrigation and debridement and possible further proximal osteotomy of the metatarsals in order to get the wound closed.
i began extensively debriding the necrotic and gangrenous tissue on the right forefoot. then subperiosteally exposed the trans metatarsals and took this back with a rongeur, far enough to where I had viable and healthy bone and bleeding tissue. This was essentially almost to the level of the tarsal metatarsal joint area. After I debrided sufficient tissue, I then worked on three additional wounds that were just on the periphery to the main wound. This was debrided extensively. I then washed 6000 cc of Gentamicin impregnated saline. This was all done after deep wound cultures were obtained.
I then was able to perform a wound closure using 2-0 Nylon suture in a vertical mattress fashion, closing all wounds except for the three peripheral wounds. A sterile saline dressing was applied to these wounds and a compressive dressing was applied to the remaining forefoot.
any suggestions????