Please help, I am not sure how to code this one.
The pt was taken to the operating room, placed in right lateral decubitus position and sedation was administered. The buttocks were examined. There was a large pilonidal type cyst with skin breakdown and a large area encompassing the midportion of both buttocks and the gluteal cleft that appeared to be large perianal fistulas with purulent drainage. This was expressed. It did extend down to the scrotum. The scrotum was edematous and thick, as well as the surrounding tissue. In the groin and pubis, the tissue was very edematous. Multiple sites were examined using a probe and hemostats and there was purulent sinus tracts throughout the pubis and groin area. It started at the panis(?) and extended down to the penis and laterally in both sides to the skin creases of the groin. There were open wounds and multiple sinus tracts. The tissue was so edematous that the probe was easily advanced through in all directions through the subcutaneous tissue. Cultures were taken or purulent discharge and an approximately 1.5 cm in diameter piece of skin and a small amount of subcutaneous tissue were excised and there were multiple sinus tracts deep to this and that was removed and sent for tissue culture. Kerlix was then applied to all of the open wounds and dressing was applied. The pt was transported to the recovery room in good condition.