CCANTER
Networker
i am still kind of confused on CPT coding for a non reducible hernia. I know that a non reducible hernia for ICD 10 CM coding will code to a hernia with obstruction/incarcerated. Do i also then use for the repair of a non reducible hernia an incarcerated repair.
I did query the provider and provider just stated not incarcerated was fluid filled. So then do i not use the diagnosis code or cpt code for an incarcerated hernia/repair?
i know i have posted a similar question but hadnt received very many responses. And now i have this situation.
here is the op note
dx is non-reducible umbilical hernia, Ascites
Local anesthetic was infiltrated in the skin around the umbilicus. A infraumbilical curvilinear incision was made over the existing scar. This was taken down to the level of the sack bluntly and the sac was dissected circumferentially down to the fascia. The attachments to the hernia sac and fascia were taken down bluntly and with electrocautery creating a space between the fascia and the peritoneal lining. The sac was entered. 6 liters ascites removed with suction. The excess sac was excised and discarded. The sac was then closed with a running 0 Vicryl suture. The subcutaneous fat was incised around the fascia freeing it up from the skin allowing the defect to be closed without any tension. The defect was about 3 cm x 1 cm.
A small 4 cm x 6 cm permanent mesh was selected. This was placed into the defect and was able to be spread out in the space between fascia and peritoneum. The defect was closed with 4 figure-of-eight 0 PDS sutures incorporating the mesh with the bites. There was no tension on closing the fascia. More local anesthetic was infiltrated into the fascia.
The wound was irrigated again. Hemostasis was ensured. Excess skin removed. The umbilical stalk was reattached to the fascia with several interrupted 0 vicryl sutures. The dermis was reapproximated with several interrupted 3-0 vicryl. The skin was closed with a running subcuticular 4-0 Monocryl stitch. A glue dressing was applied.
I did query the provider and provider just stated not incarcerated was fluid filled. So then do i not use the diagnosis code or cpt code for an incarcerated hernia/repair?
i know i have posted a similar question but hadnt received very many responses. And now i have this situation.
here is the op note
dx is non-reducible umbilical hernia, Ascites
Local anesthetic was infiltrated in the skin around the umbilicus. A infraumbilical curvilinear incision was made over the existing scar. This was taken down to the level of the sack bluntly and the sac was dissected circumferentially down to the fascia. The attachments to the hernia sac and fascia were taken down bluntly and with electrocautery creating a space between the fascia and the peritoneal lining. The sac was entered. 6 liters ascites removed with suction. The excess sac was excised and discarded. The sac was then closed with a running 0 Vicryl suture. The subcutaneous fat was incised around the fascia freeing it up from the skin allowing the defect to be closed without any tension. The defect was about 3 cm x 1 cm.
A small 4 cm x 6 cm permanent mesh was selected. This was placed into the defect and was able to be spread out in the space between fascia and peritoneum. The defect was closed with 4 figure-of-eight 0 PDS sutures incorporating the mesh with the bites. There was no tension on closing the fascia. More local anesthetic was infiltrated into the fascia.
The wound was irrigated again. Hemostasis was ensured. Excess skin removed. The umbilical stalk was reattached to the fascia with several interrupted 0 vicryl sutures. The dermis was reapproximated with several interrupted 3-0 vicryl. The skin was closed with a running subcuticular 4-0 Monocryl stitch. A glue dressing was applied.