subaponeurotic space

katysuegood@gmail.comkatysuegood@gmail.com
in CDI Talk Archive
How would you code an I&D of a subaponeurotic abscess (R hand)? Would you consider this an I&D of the fascia???

First time I have seen this terminology.

Thanks!

Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404

Comments

  • Unknown
    edited March 2016
    A subaponeurotic abscess can occur in various places where fascia limits the expansion capabilities of the collection and makes it subject to a compartment syndrome (thigh, neck, scalp, etc.). As yours is identified in the hand, I'd look to 0J9K0Z if it were done with an incision and dissection down to the dorsal compartment of the hand. Anybody with some more sage advice?

    The deep fascial spaces of the hand are potential spaces and consist of the dorsal subaponeurotic space, subfascial web space, midpalmar space, and thenar space. The dorsal subaponeurotic space lies dorsal to the extensor tendons of the hand. The subfascial web space is contiguous with the dorsal subcutaneous space of the digits. The midpalmar space is demarcated by the palmar interosseous muscles dorsally and the flexor tendons of the third, fourth, and fifth digits ventrally. Lastly, the thenar space extends from the long metacarpal bone to the thenar eminence and consists of the area between the adductor pollicis muscle dorsally and the flexor tendon of the second digit ventrally.

    These compartments are susceptible to infection by direct penetrating trauma, spread from a neighboring compartment, or hematogenous seeding. Because of the dorsal location of the lymphatics, erythema and swelling commonly appear over the dorsum of the hand, even when the injury is of palmar origin. http://misc.medscape.com/pi/iphone/medscapeapp/html/A783011-business.html

    Robert S. Gold, MD
    CEO, DCBA, Inc
    4611 Brierwood Place
    Atlanta, GA 30360
    (770) 216-9691 (Office)
    (404) 580-0204 (Cell)

  • arozhkovskayaarozhkovskaya
    edited March 2016
    Thank you, Dr. Gold, I was just thinking of you when I saw this question and tried to find out more in intranet.
    Always great to hear from you!

    Anna Rozhkovskaya, RHIT, CCS, CCS-P
    Manager, Clinical Documentation Improvement
    Memorial Healthcare System
    Health Information Management Department
    2990 Executive Way, Miramar, Fl 33025
    (954)276-9957 Office
    (954)265-6974 Mobile
    (954)441-9459 Fax


  • Unknown
    edited March 2016
    Miss you guys, Anna! Keep it warm in Florida for my next visit.

    Robert S. Gold, MD
    CEO, DCBA, Inc
    4611 Brierwood Place
    Atlanta, GA 30360
    (770) 216-9691 (Office)
    (404) 580-0204 (Cell)

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