# Lap Abdominal Wall Hernia Repair with Mesh



## Ravikirann (Apr 10, 2016)

Dear All,

The below OT notes is from my hospital. The patient has ventral hernia and doctor has performed the Lap repair of abdominal wall with mesh and the doctor has charged the CPT code 49651 but as per the OT notes i want to bill 49652. please guide which CPT code is correct.

Routine antibiotic prophylaxis to avoid mesh infection, which is a serious complication. 
Pneumoperitoneum is established with a suprapubic camera port and a port in each flank.
The contents of the sac are reduced into the abdominal cavity,
little dissection to bring the contents out with care to avoid any injury to the bowel. 
The mesh is rolled up and delivered down the first port site
and unfurled in the peritoneal cavity. It is laid over the hernial defect with a generous overlap
onto the peritoneum surrounding the defect. Positioning of the mesh is aided 
with two temporary sutures tied to the mesh extracorporeally prior to inserting it into the peritoneal cavity.
Once the mesh is unfurled, the straight needles on these sutures are passed
through the anterior abdominal wall and grasped with artery forceps where they emerge through the skin. 
Traction on these sutures lifts the mesh into position.
The mesh is secured in place with staples, every few centimetres around the perimeter, 
and the retaining sutures are then cut flush with the skin. 
The potential space of the unresected hernial sac almost inevitably fills with serous fluid, 
but the seroma resolves spontaneously over 8–12 weeks. 

Thanks and Regards
Ravi


----------



## CodingKing (Apr 10, 2016)

If its ventral its:

49652 (reducible) or 49653 (incarcerated or strangulated)

Code chosen by Dr is for inguinal recurrent


----------

