karen duke
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Patient is several months post-op for an open lung biopsy. She presented with "purulent material draining from...the previous incision." The old incision was reopened..."and there was only a sinus tract in the deeper tissues...noted to go all the way to the chest wall and with each respiration there was noted to be air insufflating from the chest to the exterior." Culture was positive for cocci. "We then explored this sinus tract. Preoperative CT scan demonstrated a very small pocket of air and it appeared that the lung was adherent to the chest wall...oversewed the alveolar pleural fistulous tract with a running 2-0 Biosyn down and back. When this was tied, it obliterated the air leak." A wound VAC was applied. The patient will return to OR for delayed closure in 7 to 10 days. I'm coding 21501 for I&D of the deep abscess and 97605 for the wound VAC. Does anyone know how to code for oversew of alveolar pleural fistula?