# 49002???



## rlcohen76 (Nov 2, 2010)

Pt is 2 days post op  Status post Supracervical Hys, LSO, - Returns to the OR for Exploratory Laparotomy, Evacuation of hemoperitoneum, Abdominal Washout, and placement of Jackson Pratt drain.

The previous pfannenstiel incision was reopened and the skin was extended 2 cm bilaterally to aid exposure. The fascia was opened by cutting the previous Vicryl sutures. Hematoma on the left rectus edge with oozing was noted on the left inferior epigastric vessels. Vascular pedicles were ligated and hemostasis assured. The peritoneal cavity was entered and hemoperitoneum was noted with a large pelvic hematoma. The hematoma was evacuated and the retractor was placed to aid surgical exposure. The bowel was then packed into the abdomen using moist lap pads. The area was religated using figure 8 vicryl sutures and hemostasis was noted. Irrigation of the pelvis was performed and no active bleeding was noted. All instruments were removed from abdomen and pelvis. A jackson pratt drain was placed in the LLQ. Subcutaneous tisses were irrigated and reinspected for hemostatsis. SKin was closed with staples .

We are debating whether 49002 is correct and wheher modifier 78 is approriate. 

Thoughts are greatly appreciated..thanks!


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## preserene (Nov 3, 2010)

I agree; that is perfect and the most appropriate reporting with this scenerio


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