The authors gathered clinical illustrations of gluteal cleft wounds and. The drainage opening is large enough to allow it to drain well. Daniel Saurborn: CT scan sufficient: MRI scans can be quite expensive. Usually asymptomatic; affects the head, neck, back, or. (170 g) 12 Triad applied directly to the wound Triad impregnated into gauze Facilitating autolytic debridement 1. Act as if they’re loaded, even if you’re. Extrapolating the reported improvement in perineal wound healing, a total number of 146 patients (73 per group) are needed to be able to detect a 20% increase in primary perineal wound healing by use of a gluteal turnover flap (from 65 to 85%), applying a Chi-Square test with a two-sided 0. Wound, ostomy, and continence (WOC) nursing was recognized as a nursing specialty by the American Nurses Association in February 2010, and the Society published the original scope and standards of WOC nursing practice in May 2010. ICD 10 code for Non-pressure chronic ulcer of buttock with unspecified severity. The 2024 edition of ICD-10-CM S31. Computed tomography (CT) with oral and rectal. 1 Given the low incidence rate of OSD at 0. [6] Physical exam findings include midline pits in the superior gluteal cleft and may be associated with cephalad or lateral tracking sinuses. The “intergluteal cleft” is the medical term for your butt crack, which is a common area for rashes. This delicate skin is more likely to get infected than psoriasis in other areas. 1. 313 - other international versions of ICD-10 L89. 00 - S71. A 71-year-old woman with no relevant medical history presented with recurrent painful erosions on the gingivae and gluteal cleft of 1 year’s duration. wound without the need for a secondary dressing. (B) Superficial flaps are established to reduce the depth of the gluteal cleft and to shift the suture line off the midline. Stage 2- The 3 P's! Pink, Partial, Painful! Stage 2 wounds are partial thickness and often resemble a very shallow ulcer with a reddish-pink wound bed. The time to healing was rapid, within 1 week in 22 patients. Deep tissue was left essentially. Gluteal cleft (also called natal cleft) is the space between the buttocks, while the gluteal fold is the area where the buttock joins the upper posterior thigh. of gluteal cleft, with dressing ‘base’ positioned to cover coccyx area. . Chronic ulcer of buttock limited to skin layer; Chronic ulcer of buttock, breakdown of skin; ICD-10-CM L98. Flexural skin has a relatively high surface temperature. The pits picking (Gips) procedures [ 18 , 20 ] were all carried out in the prone position under a general and local anesthesia combination as described before. Messages 2,335 Location ENGLEWOOD/DENVER Best answers 0. 819D for Unspecified open wound of right buttock, subsequent encounter is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes . :) Documentation is key. of gluteal cleft wounds. Of the 1,592 days with. The skin flap is then closed over the ‘shallowed’ valley and sutured to the side outside the cleft. Hypothesis: Refractory pilonidal disease is due to damage of the epidermis in the deep gluteal cleft by moisture and bacteria, rather than to damage in deep tissues. The 2024 edition of ICD-10-CM S31. INTRODUCTION. A new paradigm suggests that a procedure to change the shape of the gluteal cleft will improve results. This is the American ICD-10-CM version of S31. If there is no abscess, gluteal cleft shaving may be used as a primary or adjunct treatment measure. 309 became effective on October 1, 2023. 5). diseases of the male reproductive organs. L02. 10 for a 60/gm tube. A review of 5 cases described a characteristic clinical presentation of a butterfly-shaped bilateral gluteal cleft lesion on most patients. HCC Plus. Background: Herpes simplex virus (HSV) lesions are prone to reactivation and recurrence in response to various local or systemic triggering factors. 0):. Carefully lift the dressing edges (filmICD-10. Intertrigo is a superficial inflammatory dermatitis occurring on two closely opposed skin surfaces as a result of moisture, friction, and lack of ventilation. The authors gathered clinical illustrations of gluteal cleft wounds and conducted a literature search as a basis for presentation to conference attendees, with the goal of gaining consensus. In 93. Left untreated, the periwound will eventually break down and the. A pilonidal cyst is a cyst-like structure that develops in the upper portion of the crease between the buttocks. For wound care certification specifically, it is important to understand the basics along with the details. Pressure Ulcer of Gluteal Cleft. Most operations for pilonidal disease do not address the depth of the gluteal cleft, which is the. Bone cultures grew Morganella morganii with pathology consistent with acute osteomyelitis. 322 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 4. The flap is then closed over the ‘shallowed’ valley and sutured to the side outside the cleft. KEYWORDS: abscess, female, gluteal cleft, pilonidal cyst, pilonidal disease, women’s health P ilonidal disease (PD) is defined as a condition of the skin and subcutaneous tissue at or near the natal, or intergluteal, cleft (see Supplementary Figure S1). 2016;43(2):148-149. Abstract. S78 Traumatic amputation of hip and thigh. Patient Monitoring. A step-by-step drawing of the surgical process. Usually over a bony prominence. It is a visible border separating ass into two parts. Show abstract. sensation -pain,touch,temp,pressure. Abstract. If there is slough present, it must be staged as a Stage 3. A pilonidal cyst is a cyst or abscess (boil) located near the intergluteal cleft, otherwise known as the groove between the buttocks. Recipient vessels are commonly the gluteal vessels dissected through a muscle-splitting technique. The condition, which has an annual. 1). Pilonidal cysts tend to occur on a person’s lower back, just above the cleft of the buttocks. Hair and other debris from skin or clothing can lodge in the pores. To that end, various flap-Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. It extends from sacral level S3 or S4 and ends just inferior to the apex of the sacrum, at the level of the anus. (A) The patient in the prone position. 82 became effective on October 1, 2023. The gluteal cleft and the gluteal fold both occur normally in humans. Approximate Synonyms. 829A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. This prolonged exposure leads to irritant contact dermatitis. ICD-10-CM Code for Unspecified open wound of right buttock, subsequent encounter S31. 1 Depending upon the skin areas exposed to urine or stool and/or the use of containment devices, IAD can also extend to the inner and posterior thighs and may include other ele-ments such as candidiasis (Figures 1 and 2). Neurological examination may show motor weakness, a sensory deficit in the lower body, or decreased anal tone. 0 Traumatic amputation at hip joint. 9 - other international versions of ICD-10 L98. Unspecified open wound of right buttock, initial encounter. Recurrence and wound care needs are lowest with flap closures. metabolism-vitamin D synthesis with prescience of sunlight. Irregular surfaces could include the gluteal cleft, coccyx, perineum, buttocks, groin, face, hands, feet and other areas. Access to this feature is available in the following products: Find-A-Code Essentials. 1. The new natal cleft is less deep and smoothly transitions down toward the anus. 317 - other international versions of ICD-10 L03. Patients with fecal incontinence: • Consult with physician; consider placement of fecal. DTIs as very linear wounds with a mirror image distribution, along the edge of the medial buttocks, right along the gluteal cleft. The gluteal sulcus (also known as the gluteal fold, tuck, fold of the buttock, or horizontal gluteal crease) is an area of the body of humans and anthropoid apes, described by a horizontal crease formed by the inferior aspect of the buttocks and the posterior upper thigh. It is found in the 2022 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2021 - Sep 30, 2022 . This is the American ICD-10-CM version of L30. If there is difficulty lifting the film border, apply tape to the edge of the dressing and use the tape to lift. it went away for three weeks and then the open sore re occured last week. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM L89. Treatment usually requires having a pilonidal cyst removed surgically. 0):. Laceration of left buttock; Left buttock laceration; Stab wound of left buttock; ICD-10-CM S31. 00 [convert to ICD-9-CM] Gluteal tendinitis, unspecified hip. There are several names for this area: natal cleft, gluteal crease, gluteal crevice. A comparison of the various surgical most effectively. Pilonidal disease, especially when infected, can be confused with other conditions, which are discussed in. S78. The base was moist, pale pink with some scattered areas of yellow slough. The gluteal fat is allowed to appose and excess skin is excised to re-contour the natal cleft and allow a shallower closure away from the midline. The site of the external opening of the fistula is variable and depends on the anatomical course. Remove side release films and gently smooth each side into place. Patient has recurrence of pilonidal disease. However, wound closure using bilateral gluteal fascial advancement flaps was associated with a significantly lower rate of dehiscence when compared with standard primary closure (12% vs 40%, P < 0. (B) Sever all knee ligaments. The symptoms from pilonidal disease can vary greatly from patient to patient. Pressure ulcer of right buttock, stage 3. ASSESSMENT/PLAN: Gluteal abscess, left cheek. The intergluteal cleft is a surface anatomy landmark of the pelvis and lower limb. " Buttock is the skin location where the abscess is located. S31. functions of the skin. The characteristics of a good drainage procedure are: It is drained early, so it hasn’t become too large. Polyglactin 0 sutures were used to approximate both gluteus muscles and fasciae together covering the inter-gluteal cleft. The code is valid during the fiscal year 2023 from October 01, 2022 through September 30, 2023 for the submission of HIPAA-covered transactions. S31. 5. This is the American ICD-10-CM version of S30. You should ALWAYS treat firearms with extreme caution, no matter the circumstance. This is the American ICD-10-CM version of M25. This was the first year ICD-10-CM was implemented into the HIPAA code set. The rotating of tissue causes the gluteal cleft to shift. Grade of recommendation: 1C. IAD can erode this barrier, causing severe and uncomfortable symptoms. 829A became effective on October 1, 2023. After skin is prepared, remove the centre. Pilonidal disease is a chronic skin infection in the crease of the buttocks near the coccyx (tailbone). Healing pressure ulcer of right buttock, stage 2. 0):. Use an absorbent diaper and wrap it. On day 15, he developed atrial fibrillation with RVR and was started on IV heparin, but this was discontinued because of epistaxis and haematuria. protection. difficult-to-dress wounds with light-to-moderate exudate such as those near the gluteal cleft. Applicable To. The inferior flap thus was based laterally. Significant morbidity derives from extensive gluteal and perineal hidradenitis suppurativa caused by the disease extension and large wounds that result from surgical treatment. L02. A 4-mm punch biopsy of the gluteal cleft was performed. We use Molnlycke's silicone foam dressings for all coccyx/sacral surface wounds. • Suitable for use on neonates1. Moisture from insensible water loss and sweating cannot evaporate due to occlusion. Design: Before-and-after trial. Pilonidal disease is a reaction to hair in the gluteal cleft, in which unattached hairs injure or pierce the skin, resulting in a foreign body reaction. Body habitus may contribute to additional intertriginous sites, such as inframammary skin and. Non-healing wounds in the natal cleft are the most common reason for reoperation after excision and open treatment. 0 cm at D/C Gluteal cleft: Resolved in 11 d R buttock: Blanching erythema in. Search Results. After drainage of the gluteal abscess, the patient re-presented with faecal loss from the abscess drainage site. She denied fever, chills, weakness, fatigue. Main Outcome Measures Number healed, time to healing, number of operations required. The most common areas include: Intertrigo can also affect the skin between the buttocks. Complete offloading was prescribed by avoiding supine positioning of the patient and by using a low air-loss bed. a moisture lesion will not heal if treatedHere are some of the most common symptoms of herpes on the buttocks: skin feels itchy or burns before bumps or blisters appear. This fact alone is a testament to both the number of disease variants and the challenges with recurrence and wound management in this area. DX? dmaec True Blue. 1. In the sacral area, there are several common skin problems that require differential diagnosis, including skin tears, 3 moisture-associated skin damage (MASD), 8,9 gluteal cleft, 10 or friction injuries. 2). Code History. Exploration with a Q-Tip revealed that these two wounds communicated deep down. Intergluteal cleft. A suction drain was inserted and left for four to seven days till there was no or minimal drainage except if signs of inflammation were evident. It is also known as the “butt crack” and “intergluteal cleft. Some patients are prone to developing pilonidal abscesses – which are very painful, and often need to be drained (lanced) in order to get relief. Pilonidal cysts typically manifest as a sinus. IP is usually found in the groins, vulva, axillae, submammary folds, gluteal cleft, navel, intergluteal crease, penis, lips, and web spaces. The intergluteal cleft (a. 82 may differ. Unfortunately, wounds in the gluteal crease are not like wounds elsewhere on the body, and the usual strategies for dealing with wounds may not apply here. These codes are used. Stage 2 PU/PI: According to the National Pressure Ulcer Advisory Panel (NPUAP) a stage 2 PU/PI is defined as follows: "Partial-thickness loss of skin with exposed dermis. Then, the surgical wound is closed by rotating other tissue to cover the area. The other synonyms of gluteal cleft are anal cleft, gluteal sulcus, natal cleft and intergluteal cleft. Gluteal cleft (often see moisture damage rather than pressure damage in this area) Perianal / perineal area (often due to moisture eg. Approximate Synonyms. By palpation there is no bony prominence and it is blanchable erythema. The gluteal cleft is the groove running between each buttock, from the base of the spine to the perineum, which is the area between the anus and genitals. 3 Loose hairs trapped in the natal cleft traumatize and penetrate the skin, creating a foreign body reaction that may ultimately lead to formation of midline pits and, in some cases, secondary infection. Pilonidal sinuses are characterized by natal cleft suppuration and are thought to initially result from a hair follicle infection. This allows elevation of the gluteal region primarily as a musculofascial cutaneous flap. It is currently hypothesized to be an acquired condition with local penetration of hair follicles and debris in stretched intergluteal pores. How is the recovery for the cleft-lift procedure? Compared to the standard wide excision, it is a much easier recovery. 411 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. origin secondary to abnormal skin in the gluteal cleft,4 the current widely accepted theory describes the origin of pilonidal disease as an acquired condition intimately related to the presence of hair in the cleft. Approximate Synonyms. Study. Treatment may include cleaning and reclosing the wound and a course. 3). 3 Loose hairs trapped in the natal cleft traumatize and penetrate the skin, creating a foreign body reaction that may ultimately lead to formation of midline pits and, in some cases, secondary infection. People who are overweight and who have thick, stiff body hair are more likely to develop pilonidal disease. Under local anesthesia, the wound may be incised with a scalpel. A pilonidal cyst, also referred to as a pilonidal abscess, pilonidal sinus or sacrococcygeal fistula, is a cyst or abscess near or on the natal cleft of the buttocks that often contains hair and skin debris. 4 became effective on October 1, 2023. Located in peri-anal, gluteal, cleft, groin or buttock area. This will allow easier removal once dressing has been placed over the wound. 409A is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Pilonidal disease refers to a subcutaneous infection occurring in the upper half of the gluteal cleft. Irregular surfaces could include the gluteal cleft, coccyx, perineum, buttocks, groin, face, hands, feet and other areas. Actually, that is not the case. Excludes2: abscess of anus and rectal regions (K61. (B) Sever all knee ligaments. I mention this as something to consider because you are having to change dressings twice a day due to. on touching tissues such as in the gluteal cleft or skin folds. The cyst is almost always near the tailbone at. 000A - Unspecified open wound of lower back and pelvis without penetration into retroperitoneum [initial encounter] answers are found in the ICD-10-CM powered by Unbound Medicine. A pilonidal cyst can be extremely painful especially when sitting. Oct 16, 2008 #2 you're joking right? ? M. A 63-year-old male with a 20-year history of a chronic, recurrent sacrococcygeal pilonidal cyst was referred to our outpatient clinic. The authors gathered clinical illustrations of gluteal cleft wounds and conducted a literature search as a basis for presentation to conference attendees, with the goal of gaining consensus regarding guidelines for accurate classification of these wounds. b 14 days after surgery, 12 × 8 cm skin necrosis, prowl separation area approximately 85 × 65 cm, the purulent exudate in the space, and the original fixed anus shortened (the arrow shows. The patient reported severe itching, stinging sensation, and intermittent rash in the gluteal cleft, perineum, and perianal region, with onset of symptoms 7 months previously. Deep tissue was left essentially intact. 0): 604 Trauma to the skin, subcutaneous tissue and breast with mcc; 605 Trauma to the skin, subcutaneous tissue and breast without mcc; 963 Other multiple significant trauma with mcc; 964 Other multiple significant. 810A - other international versions of ICD-10 S30. Sometimes called the Cleft procedure, this surgery removes all the skin covering the involved area. Introduction. For more information, call 800 -840-9041or visit our website at Documenting Wounds (Part 2 - Anatomic Location) Consistency in wound documentation is of utmost. (See 'Treatment of erysipelas' above. an ulcer. A 55-year-old woman with CD and HS was referred to a dermatology clinic in July 2015 for evaluation of a peristomal rash. I do not believe surgical intervention is warranted at this time. One central aim of Wund. Applicable To. Therefore, it was decided to perform reconstructive surgery, after warning the patient of the risks. The affected skin will often be very raw and may itch or ooze. L02. Another advantage of the GT-flap over other options is the symmetrical midline scarring, thereby preserving the gluteal cleft and restoring normal perineal aesthetics (Fig. 31 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 8 is a billable diagnosis code used to specify oth disrd of the skin and subcutaneous tissue. Injury, poisoning and certain other consequences of external causes. INTRODUCTION. 8%. Prep solution usually pools along the side of the patient, not in the gluteal cleft. 323 became effective on October 1, 2023. This area is the groove between the buttocks that. 4. Lack of Oxygen. This is a result of too much exudate that hasn’t been properly managed. 4 When the skin is moist, it is. We have performed over 2 dozen cases using this technique, and all of our. • Suitable for use on neonates1. Excision and midline suture Wound closure in the midline is intended to shorten the mean duration of wound healing, yet the incidence of wound dehiscence is high, with reported rates varying from 14% to 74% ( 29 ). Then, the surgical wound is closed by rotating other tissue to cover the. Results Wounds in all 31 patients healed, 28 after a single procedure. (C) The wound after 6 weeks. On day 14, he was extubated. Without the valley and divots, debris and hairs can’t collect. He had received multiple surgical resections in the past with benign pathology. The “sitter sign” refers to the rough, thickened skin that older people often develop near the intergluteal cleft, associated with immobility and continued sitting. Pilonidal cysts tend to occur on a person’s lower back, just above the cleft of the buttocks. To read the full article, sign in and subscribe to AHA Coding Clinic ® for ICD-10-CM and ICD-10-PCS . This is a result of too much exudate that hasn’t been properly managed. Volume 11, Number 2 · Fall 2013 Wound Care Canada – Supplement 7 neck; in the axilla; under the breasts, especially if they are pendulous; in the lateral flank area; between the buttocks (gluteal cleft, intergluteal cleft); in the groin; in the creases of the knees or elbows; and between the fingers and toes. A person with a pilonidal cyst may experience swelling, pain, and skin discoloration in the affected. After washing, you need to ensure that the skin is thoroughly dried. After injecting with 0. She is a past President of the Wound, Ostomy, and Continence Nurses SocietyTM (WOCN®) and the National Pressure Injury Advisory Panel (NPIAP®). Nurses should have knowledge of the types of dressings that are appropriate for pilonidal wounds. Familiarity with complex perineal anatomy, appropriate use of imaging modalities, and the spectrum of imaging findings seen in acute perineal conditions is. L89. I've had foul smelling discharge characteristic of wound drainage that I've been struggling to pinpoint for quite a while, in the general backside region. Figure 1: Example of periwound maceration. Or, you can use a barrier film in that area. the presence of a deep gluteal cleft as the etiology of the disease. However, the. 810A may differ. packing, putting rolled up gauze in the crease, metronidazole ointment), or will this wound never stay closed without surgery due to the diseased tissue underneath the surface?Cutaneous abscess of gluteal region. 000S - Unspecified open wound of lower back and pelvis without penetration into retroperitoneum [sequela] A pilonidal cyst is a cyst or abscess (boil) located near the intergluteal cleft, otherwise known as the groove between the buttocks. Poster presented at: SAWC® Fall; September 23-25, 2010; Las Vegas, NVI need help coding this: The pt was taken to the operating room, placed in right lateral decubitus position and sedation was administered. Pilonidal cysts and sinuses are a spectrum of pilonidal disease conditions that occur between the buttocks (gluteal crease or cleft) near the tailbone in the lower back. Symptoms of an advanced infection include: swelling in the affected area. 0±8. The clinical manifestations, diagnosis, and management of pilonidal disease are presented here. 032A is grouped within Diagnostic Related Group(s) (MS-DRG v 41. 9% [51, 52, 54]. 5 cm or less CPT 11306 - Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesiona linear wound in the natal cleft between the buttocks or on the cheeks of the buttocks, with a wound often being present on both buttocks (a copy or kissing lesion). a Pictures of the treated wound in the patient with annular avulsion and anal retraction in lithotomy position (the arrow shows the edge of the anus). The ICD code L05 is used to code Pilonidal cyst. Usually over a bony prominence. The 2024 edition of ICD-10-CM Q82. Without. Product placement. By flattening the cleft, recurrence is minimized. Recently, my cleft area became red, inflamed, and. I have recommended local wound care and careful. Other names are the anal cleft, crena analis, crena interglutealis, and rima ani. The superior tip of the intergluteal. Gluteal cleft Shield Gluteal cleft shield is a cover which is used to avoid problems related to gluteal cleft. The other synonyms of gluteal cleft are anal cleft, gluteal sulcus, natal cleft and intergluteal cleft. In its. In some people, hairs will grow in the skin. A finger sweep was conducted that showed the subcu tissue. L05. . Intergluteal cleft rashes, also known as intertrigo, are a common inflammatory skin condition caused by skin-to-skin friction and intensified by heat and moisture. The sacrum is a large concave triangular bone at the base of the spine that is the fusion of sacral vertebrae S1-S5. The 2024 edition of ICD-10-CM L89. Need help with coding of this procedure. In response to an initiative spearheaded by the Wound, Ostomy and Continence Nurses Society (WOCN), new diagnosis codes for moisture-associated skin damage (MASD) were added to the current version of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). 604 Trauma to the skin, subcutaneous tissue and breast with mcc; 605 Trauma to the skin, subcutaneous tissue and breast without mcc; 963 Other multiple significant trauma with mcc; 964 Other multiple. A 35-year-old patient is pictured in 2B 6 months after combined bilateral pudendal and gluteal flap pelvic reconstruction. Sagittal STIR (a) and contrast-enhanced T1-weighted fat-suppressed (b) images show a focal region of STIR hyperintensity along the superior gluteal cleft, in the subcutaneous fat, and overlying the coccyx (arrow), consistent with a pilonidal cyst. L98. Gluteal Cleft stock photos are available in a. APR with en bloc resection of the posterior wall of the vagina. For many, a split bum crack (also known as intergluteal cleft) can be both painful and embarrassing. 24, 67 Muscle spitting. The small contralateral decubitus ulcer was treated. Psoriasis can affect the gluteal cleft. . After washing, you need to ensure that the skin is thoroughly dried. Subjects were given no background information. CH. Keep the area clean, wash it gently with mild soap, and pat it dry. Since it's a perianal wound, could I employ the same wound healing strategies that someone with a post-open-excision wound would use in order to get it to heal (e. The. 1/7. 1) Cost – Twice-a-day application of a topical ointment containing balsam peru, castor oil and trypsin (BCT) at $48. A pressure injury develops as a result of unrelieved pressure between the sacral bone and the sitting or lying surface. Shaving along the intergluteal fold and surrounding region can be used as a first-choice treatment in cases without abscess or as a standard component of the post-operative treatment in order to prevent. 5% Marcaine with epinephrine, we made a vertical incision along the gluteal cleft connecting the two wounds. (A) Incision from the gluteal cleft to popliteal fossa and guillotine distal shank amputation. Remove femur after distal mobilization and disarticulate hip posteriorly through the decubitus ulcer. Wide surgical excision is the treatment of choice and leads to cure. Intertrigo is due to genetic and environmental factors. Pilonidal disease results from an abscess, or sinus tract, in the upper part of the natal (gluteal) cleft. 8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. hoping is going to go away. 8 may differ. 2 -, S38. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. Cleft closure for the treatment of unhealed perineal sinus. One patient shares their personal tips for relief. 18 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.