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Small bowel resection

Lee Posted Fri 27th of July, 2012 16:40:29 PM

Physician performd a small bowel resection without performing an anastomosis. Instead an abdominal closure with a Trauma-Vac was used. This is the second reopening of abdomen out of five within the same month. My question is what modifier do I use with the resection, and how do I bill the temporary Trauma-Vac closure.

SuperCoder Answered Fri 27th of July, 2012 21:10:24 PM

Yes, you should be able to code wound-vac change because the service isn't considered part of the postoperative global package. Choose your code based on the wound size: either 97605 (Negative pressure wound therapy [e.g., vacuum assisted drainage collection], including topical application[s], wound assessment, and instruction[s] for ongoing care, per session; total wound[s] surface area less than or equal to 50 square centimeters) or 97606 (... total wound[s] surface area greater than 50 square centimeters).

Watch: Wound-vac therapy isn't part of postoperative global care, but should be part of the patient's wound care plan of care. Although your physician will prescribe the treatment, a non-physician practitioner usually performs the service.

Modofier 78 is the most appropriate for this,since addtional surgeries are being performed in global period

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