Wiki Need help with DX code/Integ.

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debbiefran

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My doctor regularly codes "complex abdominal wall defect." Everything leads back to 756.70 which is congenital. The majority of his patients do not have a congenital defect, and I cannot find anything under acquired. Any suggestions?
 
Well, what IS the problem?

Well, what IS this "complex abdominal wall defect"? Is he talking about wound dehisence?

Query the physician ... show him how his statement codes to a congenital malformation and ask him to use more specific/accurate language.

I find that autumn is a good time to help the physicians with these kinds of issues as that is when the new ICD9 books appear and just before the new CPT books come out. They are used to there being changes in how we do things each fall, so they're more open to the suggestions.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
Thanks, I'll speak with him.
In this situation, the patient was scheduled for reduction of a chronic recurrent ventral hernia and then reconstruction of the abdominal wall. I think his phrasing "complex abdominal wall defect" is primarily to explain that this is beyond the normal hernia repair. I did come across 738.8, thinking that may be appropriate, if he's going to insist on using this phrasing. Does that make sense to you?
Thank you for your help!
 
738 = musculoskeletal

738 is in the musculoskeletal area so, no, I don't think this would be correct.

Is there a reason you do not want to just code the recurrent ventral hernia (which should be enough)? There are several subcategories that help explain the more complex VH.

If you really want something additiona, you will need to get the physician to be more specific (example: if there is wound dehiscence of a previous repair).

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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