Wiki Surgical Wound Revision

toria11

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Please help! I've been searching and I feel like this wound dehiscence repair is more than simple closure (12020) but I'm not sure it qualifies as complex (13160)?

Indications: Patient had a new InsterStim battery placed in the right buttock. Over the last 2 weeks wound started to separate and open. Wound is clean without any discharge or erythema or induration. Presents for revision of wound.

Procedure: The would edges were excised with a 15 blade. The would was then explored and the Insterstim battery was taken out of its pocket. Would was then copiously irrigated with clindamycin and Ancef irrigation solution. Again the would appeared clear without any discharge or evidence of infection. The base of the pocket was then incised with a 15 blade and then a new pocket was developed with finger dissection underneath this pocket. The battery was then placed into this new pocket then the subcutaneous tissue was closed over with interrupted 2 0 chromic suture. Subcutaneous fat was then reapproximated with interrupted 2 0 chromic suture. Skin was then reapproximated with interrupted 3 O chromic suture. Neosporin ointment and gauze and a Tegaderm were placed on the wound.

I was leaning toward 13160 but he reopened the wound so I don't believe it would be correct.

Thoughts? Thank you!
 
I would not use 12020 as it was a layered closure, not simple closure.
What about considering it a wound revision? I would consider 13160 or 13100-13102. Not my area of expertise, but 13160 does seem right to me.
I don't think 64595 works for the battery pack.
 
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