Postop Wound Debridement

image_print

Question:7

My neurosurgeon did posterior lumbar decompression/fusion then 2 weeks post- op had to return to OR to treat a wound infection/abscess by debridement and wound washout. He also checked the fusion to make sure everything was ok which it was. I was going to use 10180 for this procedure but my doctor said that didn’t pay enough for what he did. Do you have any suggestions for me?

Answer:

It sounds like your neurosurgeon is doing 22015 (Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral) rather than 10180 (Incision and drainage, complex, postoperative wound infection).

The I&D code, 10180, is used when the wound infection involves tissue down to the fascia while 22015 is used when the wound is opened below the fascia. Since the neurosurgeon says he checked the fusion that leads us to believe the fascia was opened and 22015 might be the more accurate code. You’ll want to ask the neurosurgeon if 22015 is what he did and make sure his documentation supports it.