# Inguinal Hernia and Lipoma Umbilicus



## laura_clffrd@yahoo.com (Dec 30, 2011)

Incision was carried down subcutaneous tissue, however, there was noticed approximately a 2cm lipoma just underneath the umbilical skin that was getting in the way of further dissection.  with that in mind, it was dissected from the underlying umbilical skin down to the fascia.  There was no real umbilical hernia per se.  It was excised with cautery.  closed with figure of eight suture.  attention was then turned towards the mid line fascia and an incision was made incising the anterior rectus fascia over the muscle.  A dissecting balloon was passed underneath the rectus muscle down to the pubis and inflated.  using a 45 degree scope the anatomy was identified.  a 5mm suprabubic port was placed below the umbilical balloon port were placed in the peritoneal space.  dissection was made clear of the mid line pubic as well as the coopers ligament.  Identified an indriect sac and the cord.  It was dissected away from the cord structures and retracted laterally. then pretty much was sewed up....  
Can I code the Lipoma separate from the hernia repair? Suggestions on cpts?


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## FTessaBartels (Jan 5, 2012)

*Sounds incidental to me*

It sounds incidental to me.  Found as they were making their incision for inserting the port. They didn't make a separate incision for this.

I would not code it.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## laura_clffrd@yahoo.com (Jan 13, 2012)

Thanks! Of course it the dr. thinks it should be, but I agree


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