Stephanie_Miller
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Good morning!
I was wondering if anyone was seeing their physicians performing the TAR flaps done via laparoscopy when doing hernia repairs? If so, how do you code for this?
My physicians occasionally perform 15734 along with their hernia repairs; however I am consistently beginning to see this being done via laparosopy also. Since 15734 is technically an open procedure code, I was wondering how everyone else was coding this?
Example:
The robot was docked. Using scissors and a grasper I started by attempting to take down the peritoneum transversely hoping to use this as my flap to perform a T APP repair. Unfortunately scar tissue and the significant diastases in the infraumbilical position did not allow for this. I therefore opened up the posterior rectus sheath transversely several centimeters above the defect and then took this dissection down exposing the rectus muscles and getting into the retrorectus space flaps on either side were created and the diastases was exposed. As I continued the dissection laterally on both sides I transition from the retrorectus space through the rectus fascia and into the preperitoneal plane to complete infraumbilical TAR flaps on either side. These were taken down inferiorly all the way to the groin. I was able to achieve adequate flap dissection to be able to bring the posterior sheath in the midline.
Thanks so much for your help,
Have an incredible weekend!
Stephanie Jones, CPC, CPMA, CGSC
I was wondering if anyone was seeing their physicians performing the TAR flaps done via laparoscopy when doing hernia repairs? If so, how do you code for this?
My physicians occasionally perform 15734 along with their hernia repairs; however I am consistently beginning to see this being done via laparosopy also. Since 15734 is technically an open procedure code, I was wondering how everyone else was coding this?
Example:
The robot was docked. Using scissors and a grasper I started by attempting to take down the peritoneum transversely hoping to use this as my flap to perform a T APP repair. Unfortunately scar tissue and the significant diastases in the infraumbilical position did not allow for this. I therefore opened up the posterior rectus sheath transversely several centimeters above the defect and then took this dissection down exposing the rectus muscles and getting into the retrorectus space flaps on either side were created and the diastases was exposed. As I continued the dissection laterally on both sides I transition from the retrorectus space through the rectus fascia and into the preperitoneal plane to complete infraumbilical TAR flaps on either side. These were taken down inferiorly all the way to the groin. I was able to achieve adequate flap dissection to be able to bring the posterior sheath in the midline.
Thanks so much for your help,
Have an incredible weekend!
Stephanie Jones, CPC, CPMA, CGSC