hsmith67
Guru
Debate on the correct coding of the following operative report. Assistance is greatly appreciated.
"The parastomal hernia was located somewhat slightly superior and lateral to the conduit. We make an incision after anesthetizing the area about the 9 o'clock position outside of the ostomy bag. The subcutaneous tissue was then separated away. The hernia defect is seen the hernia sac is opened we entered the abdomen lysis of adhesions were taken down from the hernia sac and from the anterior abdominal wall from the 12:00 to 6 o'clock position. Were able to see the ileoconduit and palpate the red rubber tube within the ileal conduit. Once we felt comfortable we had identified a complete portion of the hernia sac in the ileoconduit. The fascial defect measured about 4 and half centimeters in length in a horizontal fashion.
I then reapproximate the fascia in a horizontal fashion using 0 Ethibond sutures we used a total of 5. There is no compromise or stenosis of the ileoconduit. After this was done we closed the deep layer with a 3-0 Vicryl and the skin is reapproximated with interrupted 3-0 nylon. Sterile bandages placed on the incision. We then placed the ostomy appliance in the typical fashion."
Thanks for any coding guidance!
Hunter Smith, CPC
"The parastomal hernia was located somewhat slightly superior and lateral to the conduit. We make an incision after anesthetizing the area about the 9 o'clock position outside of the ostomy bag. The subcutaneous tissue was then separated away. The hernia defect is seen the hernia sac is opened we entered the abdomen lysis of adhesions were taken down from the hernia sac and from the anterior abdominal wall from the 12:00 to 6 o'clock position. Were able to see the ileoconduit and palpate the red rubber tube within the ileal conduit. Once we felt comfortable we had identified a complete portion of the hernia sac in the ileoconduit. The fascial defect measured about 4 and half centimeters in length in a horizontal fashion.
I then reapproximate the fascia in a horizontal fashion using 0 Ethibond sutures we used a total of 5. There is no compromise or stenosis of the ileoconduit. After this was done we closed the deep layer with a 3-0 Vicryl and the skin is reapproximated with interrupted 3-0 nylon. Sterile bandages placed on the incision. We then placed the ostomy appliance in the typical fashion."
Thanks for any coding guidance!
Hunter Smith, CPC
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