# removal of infected abdominal wall mesh



## dovejsd (Apr 11, 2012)

Here is the OP note:
...He had had also previously multiple abdominal surgeries, most recent of which was placement of a Gore-Tex mesh and repair of hernia back in the summer of 2011.  He ended up with a nonhealing and draining wound in the right mid abdomen over the hernia site.  This area was then prepped with Betadine under general anesthesia.  We went ahead and extended the opening of the incision vertically above and below where the opening was noted and part of the mesh was exposed.  Incision measured about 6 to 7 cm vertically.  It was undermined on both sides and then the mesh was removed.  There was some pus around, over and under the mesh, so this was suctioned out.  Cultures were taken.  The peritoneum over the bowel was intact, at this point here because of the infection, I elected not to put another mesh at this point.  We will treat the patient with antibiotic and let him heal for several weeks and then bring him back later for mesh placement.  The wound was irrigated.  Satisfactory hemostasis was achieved.  A Blake drain was left here over the area, where the mesh was and this was brought out through a separate stab incision and secured to skin through a nylon stitch.  The midline incision was closed in 2 layers...

CPT 11008 is an add-on code, but I don't find anything to add it on to.  My research suggested an unlisted code 49999.  Any suggestions???  Thanks


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## koatsj (Apr 11, 2012)

I have only used 49999 also. I have looked at 49402 in the past but any literature I have found online point to the unlisted code.  Hope this helps you.


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## dovejsd (Apr 12, 2012)

*Thanks!*

Hmmmm...didn't even think about 49402.  Gets me thinking - thanks!!!


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## Treetoad (May 12, 2012)

I would probably go with 10180 & 11008.  Remember this is the abdominal wall and not "intra-abdominal".


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## cynthiabrown (May 23, 2012)

chap 9  in medicare policy handbook says 11005 11008


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