Article by Jan Mater Cavagnero
If 1 can not sure whether to go for pressure ulcer coding or dehisced surgical wound coding in a specific scenario, read on to find a lot more on this.Question: One of our patients was admitted to service following a revision of a pedicle or flap graft (process code 86.75). The wound is becoming known as a dehisced surgical wound as it was at start of care. The wound was originally a pressure ulcer prior to the first flap process. The depth is 2 cm while the wound bed is 50/50 granulation/challenging black eschar. And even though the wound length is 7 cm, the width is 2 cm. So does this remain a dehisced surgical wound or is it now a pressure ulcer because the flap process has met with failure? Answer: OASIS C guidance points out that this wound is no longer a pressure ulcer as soon as a flap procedure has been performed. It is a surgical wound. If the present wound started with dehiscence of the flap, it's still a dehisced wound. If the flap had healed and consequently broken down, it would be a pressure ulcer. This scenario brings to the fore an answered dilemma...As per the coding guidelines, you should code for a pressure ulcer with a muscle flap as an unstageable pressure ulcer with a code from the 707.0x Pressure ulcer) series, reporting the appropriate location in the fifth digit. You would require to follow this with 707.25x (pressure ulcer unstageable). Even so, in your situation, you also have a dehisced surgical wound. In case there are no official guidance on the matter, report the dehisced surgical wound with 998.32 (Disruption of external operation [surgical] wound) and then follow the code with a list of pressure ulcer codes. But do nicely to keep in mind that even if you could see down to the patient's bone by way of this wound, you are not coding for an open wound. That's not a right assumption in ICD-9 coding. Open wounds in actuality are trauma wounds. If the wound wasn't produced as a consequence of trauma such as a laceration puncture wound, cut, avulsion, or animal bite, it is not apt to list a code from the 870.x-897.x (Open wounds) categories. Alternatively: Complicated surgical wounds take place when a surgical wound is not healing as was expected. Some thing has lead to the surgical wound becoming complicated. Examples of complex surgical wounds are non-healing, infected, and postoperative fistulas. For more data on pressure ulcer coding and wound care coding, there are numerous sources to help you out.
About the Author
Jan Mater-Cavagnero MA, HCS-D, specializes in diagnosis coding for home health agencies, as properly as the wide selection of issues that impact the hospice business. Jan is an editor-in-chief for Eli Healthcare, where she has written Residence Wellness ICD-9 Alert for five years.
Video sample of Envision's educational healthcare training program on pressure ulcers (bed sores) developed with the American Association of Essential-Care Nurses (AACN). The program includes techniques to stop & manage pressure ulcers, patient risk factors and wound care. To preview the whole video, visit www.EnvisionInc.net or call:1-866-321-5066.
Video Rating: five / 5
