Ask Dr. Z

Would the following be 20670 or 20680? If 20680, would you please explain why? "Patient was brought to the operating room and induced under anesthesia. He received Ancef and vancomycin for antibiotic prophylaxis. Sternal wound was prepped and draped in standard sterile fashion with chlorhexidine. Timeout was observed per standard guidelines. Previous upper median sternotomy incision was reopened, and the fistulous tract was tracked down to the third manubrial wire. Further dissection continued to fully dissect the upper three manubrial wires as well as the top sternal wire completely. We sent some deep cultures. All three wires were cut and removed without any incidents. The bone itself looked well-healed with no evidence of any purulence or gross infection. The wound was then irrigated with antibiotic solution and approximated with absorbable Vicryl sutures for the deep layer to cover the bone and then several more layers of Monocryl sutures. The edges were infiltrated with lidocaine Marcaine mixture. Dressings were applied, and patient was awoken from anesthesia and transported to recovery room in fair condition."