Lindseywingate1990
Guest
I am new to coding for a ASC i need help with this OP report................
Diagnosis: Prlapsing internal and External Hemmrhoids
patient was set in prone position with buttocks stretched foreward.......thepatient was noted to have large prolapsing internal hemrhoid that were nearly circumferential, but yet they are worse in the posterior position and lateral left position. the internal hemrrhoids were dressed using Ethicon PPH stapling system.This sheath, this was placd within the rectum and anchored bilaterally with 2-0 vicryl sutures. a 2-0 prolene circumferential pursestring suture was place 6 cm above the anal verge and a open PPH staple was placed within the rectum. the pursestrring suture was attached from around the center peristomal staple, which was then closed and fired, which removed 1.5 to 2 inch wide band of internal hemmrhoids and left stapled anastomis in its place. the stapled sheath and specimen were removed. the staple arm was carefully inspected. There was a good reduction of the internal hemmroidal tissue in good apposition of the muccosal edges There were some hematoma formation anteriorly with some bleeding and this area was oversewn with several interrupted 2-0 sutures with a good hemostasis. Additionally, 2-0 vicryl suture was placed at around the repair laterally and posteriorly for additional support.
(EXTERNAL) when this was completed, there were still somewhat prominent external hemorrhoids in the right posterior and left lateral positions. In each case these external hemmrhoids were trimmed off radially oriented incision distal to the staple line. Hemostasis was maintained with electrical cuatery and the incision was closed with monocryl in running fasion to the end of the wound.
i coded this 46250 (for external hemmrhoids) and 46947(for stapling of internal hemmrhoids) am i correct at all?
Diagnosis: Prlapsing internal and External Hemmrhoids
patient was set in prone position with buttocks stretched foreward.......thepatient was noted to have large prolapsing internal hemrhoid that were nearly circumferential, but yet they are worse in the posterior position and lateral left position. the internal hemrrhoids were dressed using Ethicon PPH stapling system.This sheath, this was placd within the rectum and anchored bilaterally with 2-0 vicryl sutures. a 2-0 prolene circumferential pursestring suture was place 6 cm above the anal verge and a open PPH staple was placed within the rectum. the pursestrring suture was attached from around the center peristomal staple, which was then closed and fired, which removed 1.5 to 2 inch wide band of internal hemmrhoids and left stapled anastomis in its place. the stapled sheath and specimen were removed. the staple arm was carefully inspected. There was a good reduction of the internal hemmroidal tissue in good apposition of the muccosal edges There were some hematoma formation anteriorly with some bleeding and this area was oversewn with several interrupted 2-0 sutures with a good hemostasis. Additionally, 2-0 vicryl suture was placed at around the repair laterally and posteriorly for additional support.
(EXTERNAL) when this was completed, there were still somewhat prominent external hemorrhoids in the right posterior and left lateral positions. In each case these external hemmrhoids were trimmed off radially oriented incision distal to the staple line. Hemostasis was maintained with electrical cuatery and the incision was closed with monocryl in running fasion to the end of the wound.
i coded this 46250 (for external hemmrhoids) and 46947(for stapling of internal hemmrhoids) am i correct at all?