Kathy Posted Fri 03rd of October, 2014 11:28:22 AM
Please advise how the following would be coded: Left palm wound sustained several months ago w/retention of large piece of wood. FB had previously been partially removed however wound has festered & pt presents today for definitive treatment. Preop US confirmed position of FB. I created a 3 cm incision immediately ove the area. Dissection was carried down to hypothenar fat & there was an exuberant amount of granulation tissue & a roughly 2 cm long shard of wood was encountered & removed. I used a #15 blade to sharply excise the entire area of chronic inflammation & granulation down to hypothenar fascia. An area of attenuated skin was also excised where the wound had been chronically draining & undermined the skin flaps to facilitate tension free closure. This resulted in a T-shaped incision incorporating the previous linear incisions mentioned above. Wound was copiously irrigated & after meticulous hemostasis was confirmed. The incision was closed in a single layer using 5-0 interrupted nylon sutures.
Would procedure code 13132 w/diagnosis code 729.6 or 709.4 be correct?
SuperCoder Answered Mon 06th of October, 2014 07:12:00 AM
ICD code 709.4, Foreign body granuloma of skin and subcutaneous tissue would be more appropriate.
And, for foreign body removal with wound closure, you should use code 10121.
Code 10121 represents 'Incision and removal of foreign body, subcutaneous tissues; complicated.'