# reducible vs incarcerated hernia repair?



## BFAITHFUL (Jun 10, 2011)

Would you say this is 49505 for reducible or is it an incarerated repair???

dx: Inguinal hernia

incision brought down through the skin and subcutaneous tissues to Scarpa's. Any oozing was stopped with a bovie cautery, and self retaining retractors placed. The subcutaneous tissue is now dissected off of the anerior rectus and the external oblique fascia, exposing the roof of the canal and exposing the inguinal ligament, and the external ring. The external is opened in the direction of its fibers into the canal. We avoid any injury to the nerve roots as we open the oblique through the external ring, and lateral pass the internal ring. Self retaining retractors were adjusted. The spermatic cord and filaments are dissect4d away from fascial attachments and surrounded with a penrose drain. A large lipoma of the cord, associated with an indirect hernia, is dissected away from the cord strucutures. It contains a sliding component of preperitoneal fat. The hernia sac is opened. The fat is dissected off the hernia wall and reduced into the abdomen. we then put a pursestring through the base of the hernia sac of 0 ethibond and wer tie this. the sac is then transected with cautery, distal to the suture. we then oversew the stump of the sac. 

thank you


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## colorectal surgeon (Jun 10, 2011)

reducible


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## BFAITHFUL (Jun 13, 2011)

The following is a response I got from the coding forum at Supercoder.com, I'm still confused between the two????

The following seems to indicate that just because the hernia sac is opened is the main reason why a hernia repair is considered "incarcerated" 




Opening the hernial sac is the key factor followed by additional resections and ligations in case of Incarcerated hernia repair which is the case here, and not 49505.


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