# Diag lap w/removal of mesh w/repair  with mesh



## lindacoder (Nov 14, 2011)

Please help!!!

5 mm Optiview port was placed and abdomen insufflated with 15cm of pressure. An additional 5 mm port was placed in the right mid lateral and right lower quadrant. You could see where the preperitoneal fat was over the hernia in the midline and there was nothing really adherent to this. I dissected this up to expose underlying mesh and you could see where it was twisted upon itself. I tried to unfold this but it was very scarred down. At this point because she was having pain I thought our best option was to remove this mesh and place a new Ventralight mesh to make sure it is laid out flat I therefore freed this up and removed it completely. I switched out the 5 right mid lateral port for a 10 and brought this mesh out through this. I then measured this and thought a 5 cm Ventralight mesh would be best. I placed a 0 PDS in the four quadrants. It was wet and placed upon itself making sure that it aligned appropriately. Using the Gore suture passer, these  PDS were pulled up to the abdominal wall and then tied down. I then tacked circumferentially with AbsorbaTack in a circle as well. Upon completion this closed the defect very nicely and it lay appropriately...

Thanks for any suggestions!!


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## TonyaMichelle (Nov 14, 2011)

*Diag.lap. w/removal and repair of mesh*

I would need to know what type of hernia it is then I would use one of the laproscopic hernial repair procedures in the 49650 - 49657 category which includes insertion of mesh, with add on code 11008 (Removal of prosthetic material or mesh, abdominal wall for infection.

Hope this helps..


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## lindacoder (Nov 14, 2011)

it was an umbilical hernia repair.  The other coder in my office and I don't agree with the 11008  and feel that is only for CPT codes 10180, 11004-11006.  Are we wrong in assuming this?


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## TonyaMichelle (Nov 14, 2011)

According to the Correct Coding Initiative data there are no conflicts between the Cpt code for the laparoscopic umbilical hernia repair and 11008 as an add on code.

Hope this helps.


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