AHA Coding Clinic® for ICD-9 - 2012 Issue 3; Ask the Editor

Debridement of Eschar and Irrigation of Seroma of Mastectomy Site

The patient is a 60-year-old man who is status post right mastectomy for invasive ductal carcinoma of the right breast. The patient developed cellulitis and chronic seroma on the right chest wall at the mastectomy site. The procedure is listed as debridement of wound, evacuation of chronic seroma with pulsed irrigation of seroma site, placement of wound VAC system to constant suction. Provider documentation indicates that the eschar in the lateral third of the wound was excised down to subcutaneous tissue. The seroma cavity was entered and opened. A thorough lavage was carried out with Sims pulse irrigation utilizing 3000 ml of saline with bacitracin. Would it be appropriate to assign procedure code 86.22, Excisional debridement of wound, infection, or burn, or 86.04, Other incision with drainage of skin and subcutaneous tissue, for this admission? ...

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