knperry
Guru
I'm not sure what code to use for a open left inguinal hernia repair with plug and patch mesh. I think the codes for this surgery should be 49565 add on 49568 but I'm not sure because the 49565 doesn't say inguinal it says incisional or ventral hernia. Please read the notes below. Your input would greatly be appreicated.
After informed consent was obtained, the patient
was prepped and draped in sterile fashion. A 7-cm skin incision was made
approximately half the distance between the anterior superior iliac spine and
the pubis. Electrocautery and sharp dissection were used to dissect down to
the level of the external oblique fascia. This was incised. Further
dissection revealed a direct inguinal hernia. The hernia sac was dissected
free from the cord, taking care to preserve the vas deferens and other cord
structures. The hernia sac was ligated high and amputated. A Vicryl plug was
placed in the defect and secured in place with 3-0 Vicryl suture. The mesh
patch was then placed over the defect and secured at the level of the pubis
with a 3-0 Prolene stitch, which was run along the shelving edge and the cord
was placed through the keyhole of the mesh. 3-0 Vicryl was used to close the
wound in 2 layers and the skin was closed with a 4-0 running subcuticular
Monocryl. The wound was dressed in sterile fashion, and the patient tolerated
the procedure well.
After informed consent was obtained, the patient
was prepped and draped in sterile fashion. A 7-cm skin incision was made
approximately half the distance between the anterior superior iliac spine and
the pubis. Electrocautery and sharp dissection were used to dissect down to
the level of the external oblique fascia. This was incised. Further
dissection revealed a direct inguinal hernia. The hernia sac was dissected
free from the cord, taking care to preserve the vas deferens and other cord
structures. The hernia sac was ligated high and amputated. A Vicryl plug was
placed in the defect and secured in place with 3-0 Vicryl suture. The mesh
patch was then placed over the defect and secured at the level of the pubis
with a 3-0 Prolene stitch, which was run along the shelving edge and the cord
was placed through the keyhole of the mesh. 3-0 Vicryl was used to close the
wound in 2 layers and the skin was closed with a 4-0 running subcuticular
Monocryl. The wound was dressed in sterile fashion, and the patient tolerated
the procedure well.