AHA Coding Clinic® for ICD-9 - 2010 Issue 3; Ask the Editor

Excisional Debridement Involving Fascial Layer

The provider indicated that the patient was admitted for IV antibiotic therapy, as well as incision and drainage of a chronic nonhealing ulceration on the plantar aspect of the right foot with recent development of cellulitis and abscess in the area. The patient underwent incision and drainage (I&D) of the right foot ulceration, with insertion of vancomycin antibiotic beads. The surgeon noted that the ulceration on the plantar-lateral aspect of the heel had a sinus tract, which tracked laterally. The surgeon made an incision utilizing a #15 blade through the skin layers, down to the sinus tract to open up the area. The ulceration, sinus tract, and all fibrotic/necrotic and infected looking tissues were sharply excised. The surgeon noted that the excisional debridement encompassed the plantar fascial layer of the heel, but did not extend into bone or capsular tissue. The area was packed with vancomycin-impregnated antibiotic beads. What are the appropriate procedure codes for this case? ...

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