Wittmann Patch Abdominal Closure

If the surgeon places the patch without abdominal exploration, you should look instead to an appropriate integumentary system closure code (for instance, 13160, Secondary closure of surgical wound or dehiscence, extensive or complicated), with modifier -58 appended.

Panasonic toughbook serial number location. Since the late 1980's the concept of damage control laparotomy has emerged as a mainstay in the armamentarium of the trauma surgeon. In order to avoid the letha triad of hypothermia, coagulopathy, and metabolic acidosis; operations have been abruptly terminated after control of hemorrhage. Methods for temporary abdominal closure have subsequently evolved. This temporary abdominal closure technique employs a Velcro like material that is sutured to the fascia of the abdominal wall. This method allows for reexploration of the abdomen as well as slow re-approximation of the abdominal wall over a period of days.

This makes if possible to perform a delayed primary closure of the fascia. Trauma patients that once may have gone on to develop ventral hernieas with other temporary closure modalities are now able to be closed primarily.

Question: On several occasions, our surgeons have performed bowel surgery and have had to leave the abdomen open due to edema, etc. Several days later, the surgeon will return to the OR and place a Wittman patch on the abdomen. The surgeon might go back, still later during the same hospital stay, to close the abdomen. How should I code for these? Cara membuka file zip yang terkunci menggunakan. Pennsylvania Subscriber Answer: Initially, you should code the bowel surgery as usual, but append modifier -52 (Reduced services) to indicate that the surgeon did not perform the closure (which is an integral part of all open surgical procedures). Adding modifier -52 will not usually affect your reimbursement, but this does 'leave the door open' for a later procedure to close the abdomen.

Coding for the Wittman patch depends on what, exactly, the surgeon did. For example, the surgeon may sew in a zipper for easy reopening of the abdomen.

This will usually also include an exploration and perhaps lavage before he adds the temporary closure (whether a Wittman patch or a zipper). For this, you should report 49002-58-52 (Reopening of recent laparotomy; Staged or related procedure or service by the same physician during the postoperative period; Reduced services). If the surgeon places the patch without abdominal exploration, you should look instead to an appropriate integumentary system closure code (for instance, 13160, Secondary closure of surgical wound or dehiscence, extensive or complicated), with modifier -58 appended. In this case, as in the above case, the presence of modifier -58 tells the payer that the surgeon planned prospectively for the wound closure. For the final closure, you should once again choose between 49002-58 for closure with exploration, lavage, etc., or 13160-58 for the closure alone with no exploration or lavage.