this is going to be my most detailed question yet ….

I’m not the normal hospital coder and i don’t normally handle insurance pre-qualifications… ok — i don’t do this at all, but i’m the only one left in the building thats a coder.

We have a Pt that has had sepsis (staph susceptible to methicillin) and had surgery at a different facility for the infection in he proximal left thumb.

He is DMII and not sure if it a complication from DMII or not .. records are pending from the other facility. (i think it is — but)

The Pt wants us to continue his care and the our surgeon has debride’d (irrigation yatta yatta) the wound and applied a synthetic skin graft … the graft was a free sample.

We are now wanting to apply another graft to same site …. probably going to be another debridement …

Insurance will deny an unspecified wound left thumb …

and i wanted to code still the sepsis staph type A (im going on memory the next morning — just got in)

The surgeon stated it as a wound .. but i think that is more of an abscess now .. and should be tested again for staph …. We don’t have a lab for staph in our records yet….

anyways ,,, i’m thinking L02.511 and adding history of staph for the insurance pre-qualification

Sorry that i’m not more knowledgeable here …