Wittmann Patch Abdominal Closure

Zanyatie po razvitiyu rechi v starshej gruppe na temu professii. Od leta 1993 je clanica Izvršnega odbora Specialne olimpijade Slovenije, mednarodnega športnega programa, ki omogoca osebam z motnjo v duševnem razvoju aktivno udeležbo v razlicnih olimpijskih športih.

The Wittmann Patch is indicated for temporary bridging of abdominal wall openings where primary closure is not possible or where repeat abdominal entries are. The Wittmann Patch (Starsurgical, Burlington, WI) is a unique device which uses velcro to permit progressive abdominal closure without necessitating serial.

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? 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.

Both engines are manufactured to the highest standards of precision in Japan. The BLOK 21aM was designed with optimal fuel mileage in mind for 1/8th buggies, while the 21aP is all about power and is well suited for any 1/8th application! Ultra ps 230w rc blok pitaniya. Both engines feature the same long stroke piston and sleeve design, DLC coated crankshaft, three needle carburetor and efficient cooling head.

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.