Wiki wound closure

slc112071

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I am needing help. I have a ptatient that had a CABG 8/1. The patient's heart was too swollen to close the sternum, so the surgeon did a patch closure. He took her back in 8/8 and removed the packing material and did an irrigation of the chest. Should this be a no charge due to this being the closure of the CABG, or would you billed it out? The following is the main part of the surgery.......

The Gore-Tex patch overlying the incision was cut and removed. A sterile
Kerlix packing was also carefully removed. Sternal retractor was placed
underneath the sternal edges and opened widely. The heart and mediastinal
contents were examined. There was no evidence of active bleeding. The heart appeared much less edematous than it had 2 days ago. Surgical sites were all intact with no active bleeding. At this point, she was irrigated with copious amounts of warm water. After irrigation, the sternum was reapproximated with #7 stainless steel braided cable in an interrupted figure of-eight fashion, using the Pioneer Cable System. The sternum was reapproximated and patient's hemodynamics were monitored.
 
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