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Debridement vs complex closure

Kathy Posted Fri 06th of June, 2014 12:17:53 PM

Please advise if the following procedure should be reported with codes 11043 & 13132 & diagnosis code 882.1:
Rt. arm was exsanguinated & a tourniquet elevated to 250 mmHg. I began by debriding the entire circumference of the wound (3x2 cm)to healthy appearing skin given that it was significantly macerated. there was also some road debris in the wound that was debrided. I debrided all subQ fat down to the palmar fascia. Upon doing this I was able to oppose the thumb & this actually helped collapse the defect. Initial plan was to perform a skin graft however given that the wound was relatively oblong in shape I elected to undermine the skin edges, elevate flaps on either side & close him primarily in a single layer using 4-0 chromic sutures in a simple & horizontal mattress fashion. Sterile dressing & thumb spica splint were applied.

SuperCoder Answered Fri 06th of June, 2014 17:04:57 PM

Complex repair includes the repair of wounds requiring more than layered closure, viz., scar revision, debridement (eg, traumatic lacerations or avulsions), extensive undermining, stents or retention sutures. Necessary preparation includes creation of a limited defect for repairs or the debridement of complicated lacerations or avulsions.

Debridement is considered a separate procedure only when gross contamination requires prolonged cleansing, when appreciable amounts of devitalized or contaminated tissue are removed, or when debridement is carried out separately without immediate primary closure.

I would go for 13132 only here.

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