Hi all,
Could anyone help me with the following report please?
This was all done laparoscopically.
Once the abdomen was entered, the adhesions were taken down until the midline was approached. A fibrotic mass was noted, felt likely to represent the posterior pseudocapsule around the intra-abdominal abscess posterior to the Gore-Tex patch graft. This capsule was penetrated with a laparoscopic needle and fluid was aspirated and sent to the lab. The abscess cavity was then entered with scissors dissection, creating a plane close to the parietal peritoneum and gradually creating a disc of pseudocapsule, which was left adherent to underlying omentum. Once this disc of scar tissue was separated from the abdominal wall, the patch was noted to be densely adherent anteriorly. Multiple Pro-Tech tacks were removed and the patch was separated from it's attachments anteriorly and another abscess was encountered between the patch and the skin. This was also drained. The patch was eventually delivered through the LUQ incision. (FOR THIS PART OF THE SURGERY THE PHYSICIAN CODED 49606 AND 49021, WHICH DOESN'T SEEM RIGHT)
The physician went on to repair the ventral hernia with an AlloMax patch. (49652)
thanks for the help,
Shena Betts, CPC
Physicians' Professional Mgmt
Could anyone help me with the following report please?
This was all done laparoscopically.
Once the abdomen was entered, the adhesions were taken down until the midline was approached. A fibrotic mass was noted, felt likely to represent the posterior pseudocapsule around the intra-abdominal abscess posterior to the Gore-Tex patch graft. This capsule was penetrated with a laparoscopic needle and fluid was aspirated and sent to the lab. The abscess cavity was then entered with scissors dissection, creating a plane close to the parietal peritoneum and gradually creating a disc of pseudocapsule, which was left adherent to underlying omentum. Once this disc of scar tissue was separated from the abdominal wall, the patch was noted to be densely adherent anteriorly. Multiple Pro-Tech tacks were removed and the patch was separated from it's attachments anteriorly and another abscess was encountered between the patch and the skin. This was also drained. The patch was eventually delivered through the LUQ incision. (FOR THIS PART OF THE SURGERY THE PHYSICIAN CODED 49606 AND 49021, WHICH DOESN'T SEEM RIGHT)
The physician went on to repair the ventral hernia with an AlloMax patch. (49652)
thanks for the help,
Shena Betts, CPC
Physicians' Professional Mgmt
