Does an infection of surgical site trump the dehiscence? or do I code both?
Code both, but dehiscence trumps infection.
I don't believe there is a rule that says one automatically trumps the other... it is all relevant to the clinician's focus of care. If the patient is on IV abx for that infection and requires every other day PICC line care, but has a wound vac for the dehiscence that requires a weekly vac change, then the infection will be sequenced primary because it is that dx that is utilizing the majority of the skilled nursing services. That may not be you patient's situation, or even a common situation, but it is an example so that you can see that there is not a "cookie cutter" answer.