I think this should be 49561 and 49587 although some co workers says only the one code, can anyone help shine some light on this for me, thanks in advance.
Date of Service: 3/20/2017
Pre-operative Diagnosis: Ventral incisional hernia
Post-operative Diagnosis: same, incarcerated
Surgeon: A, MD
Assistant: B, MD
Procedure: Davinci Laparoscopic Ventral Hernia Repair, converted to open with repair of enterotomy
Findings: numerous adhesions with 4-5 cm upper midline ventral hernia and second smaller hernia at level of the umbilicus
Estimated Blood Loss: 25 cc
Specimens: none
Implants: none
Complications: mid small bowel enterotomy, noted immediately with minimal spillage.
Procedure Details:
Indications: Patient presented with an enlarging symptomatic ventral hernia for repair.
Procedure Details: The patient was brought to the operating room and placed on the table in the supine position. General anesthesia induced and maintained via endotracheal intubation. The abdomen was prepped and draped in the usual sterile fashion. Appropriate time out was performed. A left lower quadrant incision was then made and a Verees needle inserted into the abdominal cavity. The abdomen was insufflated with CO2. An 8 mm Davinci port was then placed followed by the laparoscope. Two addition 8mm Davinci ports were then placed under direct vision in the left mid and upper abdomen. The Davinci Xi was then docked and I left the table to go to the surgeon console. The hernia was identified. The incarcerated tissue was dissected out of the hernia using a combination of sharp and cautery dissection. There were two separate hernias, a larger upper midline and a smaller in the region of the umbilicus. The smaller umbilical hernia defect(s) was closed with a running 0 V-lock suture. A small mid small bowel enterotomy was made during the dissection. There was minimal spillage, < 5cc, therefore the decision was made to convert to an open repair The robot was undocked. All ports were removed. An upper midline incision was made and the 1 cm mid small bowel enterotomy was identified and repair transversely with interrupted 3-0 silk suture. Peritoneal lavage was performed with two liters of sterile saline. The hernia defect was then closed with running double looped 0 Maxon suture. The wound was irrigated, hemostasis obtained and the skin closed with staples. The patient tolerated the procedure well.
Date of Service: 3/20/2017
Pre-operative Diagnosis: Ventral incisional hernia
Post-operative Diagnosis: same, incarcerated
Surgeon: A, MD
Assistant: B, MD
Procedure: Davinci Laparoscopic Ventral Hernia Repair, converted to open with repair of enterotomy
Findings: numerous adhesions with 4-5 cm upper midline ventral hernia and second smaller hernia at level of the umbilicus
Estimated Blood Loss: 25 cc
Specimens: none
Implants: none
Complications: mid small bowel enterotomy, noted immediately with minimal spillage.
Procedure Details:
Indications: Patient presented with an enlarging symptomatic ventral hernia for repair.
Procedure Details: The patient was brought to the operating room and placed on the table in the supine position. General anesthesia induced and maintained via endotracheal intubation. The abdomen was prepped and draped in the usual sterile fashion. Appropriate time out was performed. A left lower quadrant incision was then made and a Verees needle inserted into the abdominal cavity. The abdomen was insufflated with CO2. An 8 mm Davinci port was then placed followed by the laparoscope. Two addition 8mm Davinci ports were then placed under direct vision in the left mid and upper abdomen. The Davinci Xi was then docked and I left the table to go to the surgeon console. The hernia was identified. The incarcerated tissue was dissected out of the hernia using a combination of sharp and cautery dissection. There were two separate hernias, a larger upper midline and a smaller in the region of the umbilicus. The smaller umbilical hernia defect(s) was closed with a running 0 V-lock suture. A small mid small bowel enterotomy was made during the dissection. There was minimal spillage, < 5cc, therefore the decision was made to convert to an open repair The robot was undocked. All ports were removed. An upper midline incision was made and the 1 cm mid small bowel enterotomy was identified and repair transversely with interrupted 3-0 silk suture. Peritoneal lavage was performed with two liters of sterile saline. The hernia defect was then closed with running double looped 0 Maxon suture. The wound was irrigated, hemostasis obtained and the skin closed with staples. The patient tolerated the procedure well.