# Closure of fascia only



## RFoster1 (Aug 14, 2013)

General surgeon is called in intraoperatively by the ortho team to inspect and close the fascia after a bladder repair.  General surgeon closes fascia and leaves skin closure to ortho team.  No mention of size of repair.

Would this be 12031,52?


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## FTessaBartels (Aug 19, 2013)

*Huh???*

Why is ORTHO repairing a Bladder?    

Without seeing all the operative note(s) I can't be sure, but it's possible that the general surgeon is serving as an assist OR a co-surgeon to the primary surgeon.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## RFoster1 (Aug 21, 2013)

Thank you for your reply.  Here is the report:

Reason for procedure:
The patient is a 12 year old gentleman who was involved in a motor vehicle crash on the 11th in which he suffered an intraperitoneal bladder rupture that underwent repair at an outside facility.  In addition, he suffered multiple pelvic fractures that required fixation by the orthopedic surgery team.  The general surgery team was consulted intraoperatively by the orthopedic team to assess the abdominal wall fascia at the site of the previous laparotomy and to assist in closure.

Intraoperative findings:
The bladder repair appeared to be intact.  The fascia was healthy and it came together without undo tension.

Procedure in detail:
The general surgery team was called in after the orthopedic portion of the case had completed to assess the viability of the fascia and closure.  The fascia appeared intact and viable and there was no noted tension with the fascia pulled together.  A series of interrupted figure-of-eight 0 PDS sutures were used to close the fascia of the low midline abdominal incision.  The orthopedic team was then left to close the skin.


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## RFoster1 (Aug 21, 2013)

49900 was suggested by a co-worker.


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## FTessaBartels (Sep 12, 2013)

*Co-surgery*

This is a perfect example of a cosurgery.  If Ortho had not called General surgery, Ortho would have done the entire closure (fascia & skin) themselves ... correct?  

So you use the same code(s) for Ortho and General Surgery with a -62 modifier on both.

Both surgeons must dictate an operative report. 

The ortho team probably won't like this but the fact is the payment for the procedure INCLUDES closing the operative wound and Ortho left a good portion of the closure to general surgery.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## RFoster1 (Sep 16, 2013)

Yes, it absolutely did help.  Thank you so much!


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