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Debridment Fistula CPT

Everyone….I’ve found codes for Debridement of anal fissure, but struggling with code for Fistula Debridement…..since this note lists utilization of silver nitrate stick would 17250 make sense in this case? I’m shying away from the debridement codes (11042-11043)because I feel there should be something more descriptive of this procedure. Take a look and please let me know what you think:

Procedure performed: Debridement of perianal fistula

Description of Procedure: After informed consent, the patient was taken to the operating room and given appropriate IV antibiotics for anal surgery, and the patient was placed in the left lateral decubitus position. We did not want to use prone because of her stoma and her body habitus. Once she was in that position, the buttocks were taped apart, and the area was numbed with roughly 10 mL of Marcaine admixed with lidocaine with epinephrine and Toradol. Once the block was in place we were able to gently curette out the tract with a small bone curettage getting a lot of granulation tissue. There was no evidence of any malignancy or any other disease within this. We went ahead and curetted it several times, irrigating with saline, and then used a silver nitrate probe stick to also remove any granulation tissue going around that. Once again, we irrigated that out and scraped it one more time with a bone curette, and then irrigated with saline followed by irrigation with Marcaine with epinephrine. The patient tolerated the procedure very well and was taken to the recovery room in stable condition.

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