# removal infected mesh



## nabernhardt (Feb 1, 2012)

I know the 11008 for the removal.  Wanted to make sure that I had enough documentation to support 11005?
Infected mesh from previous umbilical hernia repair with
sinus tract.
PROCEDURE: With the patient in the supine position with good intravenous sedation and
monitoring per anesthesia, the abdomen was scrubbed and prepped in the normal manner then draped sterilely. Local anesthesia was injected around the umbilicus in a field block. The previous infraumbilical skin incision was utilized and carried down through the scar and subcutaneous tissue. The skin of the umbilicus was then dissected free from the underlying tissue. The sinus tract was identified and did tract to the level of previous sutures and then subsequently beyond the level of the sutures all the way down to the underlying mesh. It was elected to completely remove this mesh. The mesh was freed from the surrounding structures with careful spreading motion of the Metzenbaum scissors and cutting cautiously to avoid any injury to underlying structures. The mesh was completely removed from the abdominal cavity and subfascial location with this manner. After removal of the mesh, the area was inspected. Cautious use of the electrocautery device was used for hemostasis. The fascia was then débrided along its wound edges and then closed with running 0-PDS suture. This resulted in god hernia repair. The skin of the umbilicus was then inspected and débrided slightly. It was then closed with interrupted sutures of 4-0 Vicryl in the deep layer, attempting to evert the skin externally and not go through the skin with the sutures. The area was reattached to the fascia again with a 4-0 Vicryl suture. The skin was then closed with a running subcuticular closure of 4-0 after irrigating the subcutaneous space. The wound was then closed further with skin glue.


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## jk2003 (Feb 1, 2012)

Yes, you do


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## nabernhardt (Feb 1, 2012)

thanks!


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## nabernhardt (Feb 1, 2012)

a quick question what if the patient is OBS status and the 11005 says for inpatient status only?
can I still use the 11005?
thanks


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## btadlock1 (Feb 1, 2012)

nabernhardt said:


> a quick question what if the patient is OBS status and the 11005 says for inpatient status only?
> can I still use the 11005?
> thanks



Where do you see that it says 'inpatient status only'? I just see "Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing tissue infection; abdominal wall, with or without fascial closure" for 11005...


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## nabernhardt (Feb 1, 2012)

oh maybe its not then?  just when I ran it through our encoder it said inpatient service only?


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