I need help here, unsure of how to code this one 
Technique
Patient was seen in the preoperative holding area. The correct operative site was marked. Verbal and written consent was obtained. She was transferred to the operative suite placed supine on the Hana table and properly positioned against the perineal post. All bony prominences were well padded. The right hip was then prepped and draped in a normal sterile fashion. A time-out was performed and all those in attendance were in agreement with the correct operative site and procedure to be performed.
A 10 blade scalpel used to incise through the previous incision to the level of the fascia. Hemostasis was maintained with electrocautery. There was no purulence or significant seroma encountered. The subdermal fat layer was visualized and found to have some small minimal areas of fat necrosis but otherwise no abnormal findings. The fibrous tissue from the healing incision was debrided with a combination of sharp and blunt dissection. This was performed with a rongeur, a curette, and lap sponges. The fascial layer was visualized and investigated with palpation demonstrating no sinus tracts or fascial defects. 3 L of sterile saline was thoroughly irrigated through the superficial layers in the supra fascial planes. An 18 gauge spinal needle was then used to perform attempted aspiration of the right hip joint but a dry tap was performed x3 with no fluid encountered. The previous incision edges were then sharply debrided with a 15 blade scalpel to encounter good perfused skin.
The subdermal fat layer was reapproximated with a 2 0 Monocryl in an inverted simple fashion. The skin was then reapproximated with a 2 0 nylon in a horizontal mattress fashion. The skin appeared to be well perfused after closure. A Provena negative pressure wound therapy dressing was then placed and found to have good suction. The patient was awoken from anesthesia and transferred to the PACU in stable condition. All needle and scrubbed counts were correct at the end the case x2.
Technique
Patient was seen in the preoperative holding area. The correct operative site was marked. Verbal and written consent was obtained. She was transferred to the operative suite placed supine on the Hana table and properly positioned against the perineal post. All bony prominences were well padded. The right hip was then prepped and draped in a normal sterile fashion. A time-out was performed and all those in attendance were in agreement with the correct operative site and procedure to be performed.
A 10 blade scalpel used to incise through the previous incision to the level of the fascia. Hemostasis was maintained with electrocautery. There was no purulence or significant seroma encountered. The subdermal fat layer was visualized and found to have some small minimal areas of fat necrosis but otherwise no abnormal findings. The fibrous tissue from the healing incision was debrided with a combination of sharp and blunt dissection. This was performed with a rongeur, a curette, and lap sponges. The fascial layer was visualized and investigated with palpation demonstrating no sinus tracts or fascial defects. 3 L of sterile saline was thoroughly irrigated through the superficial layers in the supra fascial planes. An 18 gauge spinal needle was then used to perform attempted aspiration of the right hip joint but a dry tap was performed x3 with no fluid encountered. The previous incision edges were then sharply debrided with a 15 blade scalpel to encounter good perfused skin.
The subdermal fat layer was reapproximated with a 2 0 Monocryl in an inverted simple fashion. The skin was then reapproximated with a 2 0 nylon in a horizontal mattress fashion. The skin appeared to be well perfused after closure. A Provena negative pressure wound therapy dressing was then placed and found to have good suction. The patient was awoken from anesthesia and transferred to the PACU in stable condition. All needle and scrubbed counts were correct at the end the case x2.