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Wiki Severe compund laceration w/wedge excision

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lchiar41

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I could really use some help with coding this, I am not sure just to code 40650 or the excision also 40510

OP reads:

She had a severe contused comminuted a avulsive type laceration of the lower lip sustained after a fall.
She had a severe contused a pulse of-type laceration of her lower lip. It was felt that was best to do a wedge excision therefore a wedge excision nof the full thickness of lip including skin, fobicularis oris muscle, vermillion and full thickness of lip and oral mucosa of lower lip approximately 3 x 1 cm was excised through and through. Bleeders encountered were electrocoagulated and the wound closed a following fashion 4-0 Vicryl to the muscle 4-0 Vicryl to the mucosa and 5-0 5-0 nylon to the cutaneous surface on. The tissue with bacitracin and to return to see us for suture removal
 
40510

Since the excision (40510) include primary closure, I'd be inclined to code only 40510.

However ... your op note is very confusing ... I realize this may be that you mistyped, but in one place you state it is NOT full-thickness and then later in the same line of type you state that it IS full-thickness.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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