Wiki is the hernia bundled??


Wallingford, CT
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I am thinking the hernia is not billable with other procedure--any help?

In the OR 2 gm of Ancef were administered. DVT prophylaxis was maintained with pneumatic foot pumps and SCD hose. Subcutaneous tissue Heparin was given in the arm prior to patient's arrival earlier in the day. The lower abdominal skin markings were incised in a transverse fashion in the lower abdominal skin crease. A flap was raised superiorly up to the region of the umbilicus and marked preoperatively. The LigaSure device and 2-0 silk sutures were used for hemostasis. The umbilical stalk was then incised at skin level and bluntly dissected down to the fascia. I completed elevation of the flaps in the midline by performing division of the umbilical stalk. A 1 cm hernia was found. This was closed transversely with a running loop 0 nylon. I did infiltrate this region with 0.5% Marcaine with epinephrine 10 mL. We then excised the flap of redundant skin. My preoperative markings were appropriate as confirmed with the Pitanguy marking device. Closure was done over 2 JP's placed through stab sites in the left and right side. Scarpa's was closed with interrupted 2-0 Vicryl. Dermis was closed with interrupted 3-0 Vicryl and the skin was closed with running subcuticular 4-0 Vicryl and glue. No complications were encountered and sponge counts, needle counts and instrument counts were correct x3.

From what you have listed here, it doesn't appear that the hernia repair was done through a separate incision. I would say it's bundled.
Stephanie Baxter, CPC, COSC