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excision of a pilonidal cyst with adjacent tissue transfer

Rebecca Posted Tue 07th of July, 2020 11:13:40 AM
A skin incision was created to excise the pilonidal cyst, and was extended to the right lateral skin safe zone marking for the Bascom cleft procedure. The underlying cystic material was identified, debrided with gauze and cautery, irrigated and aspirated. Primary cavity dimensions were 3 x 3 cm. On the left, the skin is elevated from the subcutaneous tissue along Scarpa's fascia, to allow the skin to be bridged across the natal cleft. Secondary cavity is 6 x 3 cm, with a total of 27 square cm of mobilized tissue. The subcutaneous tissue and the natal cleft was then closely approximated with interrupted 3-0 PDS sutures closing the defect created by excision of the pilonidal cyst. A 15-French Blake drain was placed into the incision, out through a separate stab incision, sutured to the skin with a 2-0 nylon, and then the skin was reapproximated by bringing the skin of the left buttock to the safe zone incision line on the right, thereby lifting the natal cleft. Skin was closed with interrupted 3-0 PDS and 3-0 Monocryl suture. A wound VAC was then placed. since ATT was done i believe the correct coding would be 11700,14000-however maybe not -the buttock is not considered part of the trunk so i dont this this would be correct and i cant use 14301 because the total att was 27 sq cm so maybe in this case 11772 would be the correct code . ty
SuperCoder Answered Thu 09th of July, 2020 08:28:51 AM
Hi Rebecca nbsp Thanks for your question For excision of pilonidal cyst If the provider would have drained the pus excised the entire cyst down to the fascia along with the surrounding margin performed extensive dissection and debridement of infected tissue or there were more than one cyst only then...
Rebecca Posted Thu 09th of July, 2020 14:17:19 PM
GREAT TY
SuperCoder Answered Fri 10th of July, 2020 01:39:14 AM

Thank you, happy to help.

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