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Multiple Ventral Incsional Hernia Repairs

Nicole Posted Fri 11th of September, 2015 08:39:50 AM

The abdomen was explored through the midline and the swiss cheese defect along the midline was identified from the epigastric region down to the mid hypogastric region. The hernia was incised sharply to free the contents of the hernia. Care was taken to avoid injuring the small bowel which was contained in 2 of the hernias and omentum within the rest. A total of 5 hernias were identified. Once the contents were reduced the dowel was dissected free of the anterior abdominal wall as well as the omentum. This required extensive adhesiolysis. After the adhesions had been lysed the defect was measured. The excess splayed fascia was excised down to healthy fascia along the midline and a 10x12 inch bard mesh was then trimmed to approximate the 9x11 inch echo mesh. The Mesh was secure proximally and distally using transfixing suture of 4-0 prolene. The fascia was closed along the midline. The stem was passed through the midline fascia. The closure along the fascia was performed using interrupted 3-0 vicryl sutures after the wound had been irrigated with saline solution. The skin was closed using skin clips. Prior to closing the fascia 2 left lower quadrant 5mm trocars were placed along the abdominal wall between the anterior axillary line and mid axillary lines, 2 were placed on the right side as well. Pneumonperitoneum was created. The stem for the echo mesh was cut and echo balloon was then inflated and the mesh was then pulled against the abdominal wall and tacked down.

Is the repair just the 49561 x5 or would this convert to 49655 because the mesh was placed laproscopically? Or is there a separate code for laparoscopic placement of mesh?

Any help would be great, thank you

SuperCoder Answered Mon 14th of September, 2015 02:05:59 AM

AAE does not provide coding for operative reports and chart notes.
SuperCoder offers SuperCoding on Demand (SOD) (http://www.supercoder.com/coding-answers/coding-on-demand) for coding of an operative report or chart note and you can contact (866)228-9252 or e-mail customerservice@supercoder.com for more information.

Nicole Posted Mon 14th of September, 2015 11:27:59 AM

I was not asking you to code this? I had provided codes at the bottom of the dictation and was simply wanting confirmation of the codes I had provided. The format that was just submitted has never been an issue in the past.

SuperCoder Answered Tue 15th of September, 2015 08:28:25 AM

This is under discussion. We will get back to you on it.

SuperCoder Answered Wed 16th of September, 2015 03:04:44 AM

To verify the codes billed are correct, requires complete review of the operative report which qualifies it for SOD service. Kindly get in touch with SOD.
AAE does not provide coding for operative reports and chart notes.
SuperCoder offers SuperCoding on Demand (SOD) (http://www.supercoder.com/coding-answers/coding-on-demand) for coding of an operative report or chart note and you can contact (866)228-9252 or e-mail customerservice@supercoder.com for more information.

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