Hi all,
My APNP replaced a "wound manager pouch." Is there a way to bill for it separately?
I think it's bundled with the procedure as part of the closure, wound management care, but thought I'd check. The replacement of the pouch was performed a few days after the procedure because it was leaking. These usually have to be replaced periodically. It was performed at bedside. It is similar to Wound Vac, just less. I feel it should be separately billable since it does take a skilled APNP time and effort to perform this, but cannot find supporting info.
Any input is appreciated. Thank you in advance.
Wound Manager Change/EC Fistula
Diagnosis: Enterocutanous Fistula, Midline Wound
Using advanced techniques wound manager to wound and EC fistula changed by APNP.
Procedure:
- Old wound manager that was leaking on left side was removed.
- Cleansed skin using gauze and wet wipes.
- Crusted peri wound using ostomy powder and cavilon spray.
- Used ostomy rings to folds and skin edges to assist with seal. Used ostomy paste over the ostomy rings.
- Cut wound manager hole to size of wound. Peeled back putty on the pouch on sides to trim so it fits better to width of abdomen given close proximity to drains/JT.
- Sealed left edge with additional ostomy paste and VAC drape due to this being location of most frequent leaking.
Items applied: Large wound manager, ostomy paste, ostomy rings (4in x 3), cavilon spray, ostomy powder
Wound description: Midline incision with glossy pale tissue to superior wound, inferior incision with some maceration to skin edges, opening with small bud of bowel near suture noted to inferior incision.
Drainage description: Thin yellow/brown output
Inflammation present: No
Necrotic tissue/slough present: No
Pain present independent from dressing changes: Yes
Selective Excisional Debridement with removal of necrotic material just above the level of viable tissue was not performed.
Thanks all !
My APNP replaced a "wound manager pouch." Is there a way to bill for it separately?
I think it's bundled with the procedure as part of the closure, wound management care, but thought I'd check. The replacement of the pouch was performed a few days after the procedure because it was leaking. These usually have to be replaced periodically. It was performed at bedside. It is similar to Wound Vac, just less. I feel it should be separately billable since it does take a skilled APNP time and effort to perform this, but cannot find supporting info.
Any input is appreciated. Thank you in advance.
Wound Manager Change/EC Fistula
Diagnosis: Enterocutanous Fistula, Midline Wound
Using advanced techniques wound manager to wound and EC fistula changed by APNP.
Procedure:
- Old wound manager that was leaking on left side was removed.
- Cleansed skin using gauze and wet wipes.
- Crusted peri wound using ostomy powder and cavilon spray.
- Used ostomy rings to folds and skin edges to assist with seal. Used ostomy paste over the ostomy rings.
- Cut wound manager hole to size of wound. Peeled back putty on the pouch on sides to trim so it fits better to width of abdomen given close proximity to drains/JT.
- Sealed left edge with additional ostomy paste and VAC drape due to this being location of most frequent leaking.
Items applied: Large wound manager, ostomy paste, ostomy rings (4in x 3), cavilon spray, ostomy powder
Wound description: Midline incision with glossy pale tissue to superior wound, inferior incision with some maceration to skin edges, opening with small bud of bowel near suture noted to inferior incision.
Drainage description: Thin yellow/brown output
Inflammation present: No
Necrotic tissue/slough present: No
Pain present independent from dressing changes: Yes
Selective Excisional Debridement with removal of necrotic material just above the level of viable tissue was not performed.
Thanks all !