10180 vs 97605/06
The following descriptions are from Encoder Pro
10180 - This procedure treats an infected postoperative wound. A more complex than usual incision and drainage procedure is necessary to remove the fluid and allow the surgical wound to heal. The physician first removes the surgical sutures or staples and/or makes additional incisions into the skin. The wound is drained of infected fluid. Any necrotic tissue is removed from the surgical site and the wound is irrigated. The wound may be sutured closed or packed open with gauze to allow additional drainage. If closed, the surgical site may have suction or latex drains placed into the wound. If packed open, the wound may be sutured again during a later procedure. (emphasis added by FTB)
11005- Debridement is carried out for a severe type of tissue infection that causes gangrenous changes, systemic disease, and tissue death. These types of infections are caused by virulent strains of bacteria, such as "flesh-eating" streptococcus, and affect the skin, subcutaneous fat, muscle tissue, and muscle fascia. Surgery is performed immediately upon diagnosis to open and drain the infected area, excise the dead or necrotic tissue. Report 11005 for the abdominal wall, with or without surgical closure of the abdominal fascia.
49002 - The physician reopens the incision of a recent laparotomy before the incision has fully healed to control bleeding, remove packing, or drain a postoperative infection.
HOWEVER -- you mention using wound vac placement, with these repeat washouts (as many as 20 in post op period). I'm wondering if what you should be coding is the wound vac only ... 97605-97606.
F Tessa Bartels, CPC, CEMC
