Question

Operative Report DIAGNOSIS: OPERATION: Nonhealing ischemic ulcer Debridement of soft tissue of the right first metatarsophalangeal head area wound with application of MIRODERM OPERATIVE FINDINGS: Fibrotic wound base noted to the right foot first metatarsophalangeal joint wound, some bleeding noted upon debridement. No underlying purulence noted. INDICATION FOR PROCEDURE: This is an 86-year-old female with history of peripheral vascular disease and nonhealing ischemic ulcer to the right first metatarsophalangeal head area. The wound developed from previous failed primary closure and the patient has been receiving local wound care without significant improvement of wound. Wound has no signs of infection. Debridement of wound with application of MIRODERM, a new porcine liver derived product, has been discussed in detail with the patient. The patient understands all the risks and benefits of surgery including being increased bleeding, increased pain, increased numbness, infection, nonhealing surgical wound and possibility of further procedures. Consent signed. PROCEDURE IN DETAIL: The patient was brought into the operating room and placed on the operating table in supine position. Upon IV sedation, local anesthesia was brought about the patient's right lower extremity using 12 mL of 1:1 mixture of 1% lidocaine and 0.5% Marcaine. The right foot was then prepped and draped in usual aseptic manner. No tourniquet was used. Attention was then directed to the right foot at the first metatarsophalangeal joint where a fibrotic wound approximately x 4 cm was noted. Using a rongeur, the wound was debrided to bleeding and granular tissue. The wound was irrigated with copious amount of double antibiotic solution. MIRODERM was then applied to the first metatarsophalangeal head wound site. Using a staple gun, the wound matrix was secured onto the skin into the wound. The wound was then covered with a layer of Adaptic. The patient tolerated the procedure well and was transferred back to the post-anesthesia care unit under the care of the anesthesiologist in apparent stable condition. All sponge count and needle count were accounted for at the end of the case.

Assign ICD-10-PCS Code(s)

If you have the time can your please elaborate on each of the question.

Section (Main Index Term)?

Body System( Sub Index Term?

Root Operation?

Body Part?

Approach?

Device:

Qualifier?

How many code(s) are needed to dissect this operative report?

Final code(s)

Answer 1

Name of Procedure:-Debridement of soft tissue of the right first metatarsophalangeal head area wound with application of MIRODERM.

ICD-10-PCS Code XHRPXL2

Section X

Body system:- H skin , subcutaneous

Body part :- P skin

Root operation:-- R Replacement

Approach :- X external

Device/Substance/Technology :- L skin substitute,porcine liver derived

Qualifier:- 2 new technology group 2

Only one code is needed to dissect this operative report.

Final code:- XHRPXL2