gabetteyoung@yahoo.com
Contributor
I am hoping someone can point me in the right directions with this. One of my doctors performed a right inguinal hernia repair and an excision of squamous-cell carcinoma in situ of suprapubic skin during the same operative episode.
From the operative report: "Inspection of the suprapubic area just above the base of the penis, there was approximately a 3 cm skin lesion, which had previously been biopsied and pathology revealed squamous-cell carcinoma in situ. I made an elliptical incision around the lesion back to grossly clear margins circumferentially and then extended this into my normal right inguinal hernia repair incision, which is superior and parallel with the right inguinal ligament. Prior to incision, I did inject with 0.25% Marcaine with epinephrine. I excised the skin lesion and placed a single suture on the right and 2 superiorly. Electrocautery was then used to dissect through the subcutaneous tissue and Scarpa's layer down to the external oblique aponeurosis. Small incision was made parallel with the fibers and this was extended with Metzenbaum scissors to the external ring and a short distance laterally. Blunt finger dissection was used to dissect round the cord structures, as well as the protruding hernia contents...." I didn't include the rest of the operative report because it only deals with the hernia repair from this point forward.
Can I code both the excision and the hernia repair? I'm confused by this since it appears he just extended the incision from the excision of the lesion to the hernia repair.
Any assistance would be greatly appreciated!
Gabette
From the operative report: "Inspection of the suprapubic area just above the base of the penis, there was approximately a 3 cm skin lesion, which had previously been biopsied and pathology revealed squamous-cell carcinoma in situ. I made an elliptical incision around the lesion back to grossly clear margins circumferentially and then extended this into my normal right inguinal hernia repair incision, which is superior and parallel with the right inguinal ligament. Prior to incision, I did inject with 0.25% Marcaine with epinephrine. I excised the skin lesion and placed a single suture on the right and 2 superiorly. Electrocautery was then used to dissect through the subcutaneous tissue and Scarpa's layer down to the external oblique aponeurosis. Small incision was made parallel with the fibers and this was extended with Metzenbaum scissors to the external ring and a short distance laterally. Blunt finger dissection was used to dissect round the cord structures, as well as the protruding hernia contents...." I didn't include the rest of the operative report because it only deals with the hernia repair from this point forward.
Can I code both the excision and the hernia repair? I'm confused by this since it appears he just extended the incision from the excision of the lesion to the hernia repair.
Any assistance would be greatly appreciated!
Gabette
