I can't tell what code to use for the I&D with an umbilical hernia. It sounds like the surgeon does an I&D on the surface for an umbilicus infection but then states there was an abscess underneath the umbilicus...so two??? Would it be 10060-61 or is it more than that? OR do I not code for it since I'm coding 49587 for the hernia?
Here's the note. Any ideas???
Patient was originally seen in consultation regarding an umbilical hernia which was chronically incarcerated with omental or preperitoneal fat. She had been scheduled for an elective operation and when she showed up today she had been seen in the ER the previous night with some erythema around the umbilicus. It was felt she had developed a soft tissue infection there and we proceeded with surgery. I felt that if she had developed a soft tissue fluid collection there it would need to brained in either event.
Patient was brought to the operating suite where identity and procedure were confirmed and she was placed on the table in the supine position. General anesthesia was induced. The abdomen was prepped and draped steriley and an infraumbilical incision was made. Immediately when the skin was opened thick green purulent material drained spontaneously from the sub umbilical cavity about 3-5ccs in side. This was all evacuated and irrigated and appeared to be an abscess beneath the umbilicus related to some small amount of necrosed incarcerated preperitoneal fat. This was excised. The hernia defect was only about 5-7mm in size and was closed with a single 0-vicryl figure of eight suture. The wound was thoroughly irrigated and hemostasis was confirmed.
Any thoughts???
Here's the note. Any ideas???
Patient was originally seen in consultation regarding an umbilical hernia which was chronically incarcerated with omental or preperitoneal fat. She had been scheduled for an elective operation and when she showed up today she had been seen in the ER the previous night with some erythema around the umbilicus. It was felt she had developed a soft tissue infection there and we proceeded with surgery. I felt that if she had developed a soft tissue fluid collection there it would need to brained in either event.
Patient was brought to the operating suite where identity and procedure were confirmed and she was placed on the table in the supine position. General anesthesia was induced. The abdomen was prepped and draped steriley and an infraumbilical incision was made. Immediately when the skin was opened thick green purulent material drained spontaneously from the sub umbilical cavity about 3-5ccs in side. This was all evacuated and irrigated and appeared to be an abscess beneath the umbilicus related to some small amount of necrosed incarcerated preperitoneal fat. This was excised. The hernia defect was only about 5-7mm in size and was closed with a single 0-vicryl figure of eight suture. The wound was thoroughly irrigated and hemostasis was confirmed.
Any thoughts???