AHA Coding Clinic® for HCPCS - 2021 Issue 3; In this Issue
Secondary wound closure
A patient presented with a past history of an open reduction internal fixation for a medial tibial plateau fracture seven years prior. Approximately six weeks ago, she presented for incision and drainage (I&D) with debridement/excision and washout of the right knee due to septic pre-patellar and pre-infrapatellar bursitis. Following the procedure, a wound VAC was placed on the right anterior knee. The patient now presents for secondary closure of the I&D wound and re-application of a wound VAC. There was a 2.5 cm wide x 5.0 cm long I&D wound that was shallow and covered with granulation tissue over the anterior aspect of the right knee. A knife was utilized to undermine the skin and subcutaneous tissue margins of the wound for a distance of approximately 2-3 cm. The margins of the wound were freshened by sharp dissection and the skin and subcutaneous tissue edges were approximated with sutures. Would this procedure be coded as a simple secondary/delayed closure with CPT code 12020 or a delayed intermediate closure and reported with CPT code 17999? ...
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