Wiki surgical question

[dee ostrosky]

Patient is mobidly obese, previously (2 yrs ago) sustained a hematoma from a spinal surgery. The patient's entire abdomen, torso, and upper pevlis drapped in usual manner. Incision made at the infero-umbilical level through skin, subq. A capsulotomy incision was made through the hematoma pocket. The incision was not made in the original spinal surgery incision. hematoma was evacuated, approx 15 liters, the capsule extended over the entire flank up to the thoracic level. wound vac applied.

We are thinking about 35840 - however this code indicates opening the previous incision. Any ideas??

Surgery # 2 - 2 days later --- excisional debriedement of skin, subq measuring over 2x3 feet; total posterior wall capsulectomy of hematoma capsule; partial capsulectomy of anterior hematoma capsule as well as capsulotomy. both measuring 2 x 3 feet; insertion of penrose drains--------ideas???

Thanks

 

[ASH527]

what about codes 10140 with modifier 22 and 97605 for the wound vac placement

 

[dee ostrosky]

Thanks - surgeon thinks procedure is much more extensive than 10140 - even with 22 - have the vac code