Wiki Repair of combined inguinal hernia with incisional hernia defect?


Perryville, MO
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I'm stuck on this mainly due to the mention that this is a combined inguinal and incisional hernia. The pertinent details of the op note read:

Preperitoneal repair of right abd wall hernia utilizing mesh

....4 cm transverse incision was made at the right lower abdominal wall...carried down to the rectus abdominis musculature. The preperitoneal plane was then developed and extended down to the pubic tubercle and the pt was found to have combined inguinal hernia with incisional hernia defects. Mesh was placed in the preperitoneal plane obliterating both hernia defects and secured to the anterior abdominal wall with sutures. Decision was made to proceed with closure of the overlying transversalis fascia......

Any suggestions?
49560 49568. If Dr felt and documented more work than they normally do on a 49560, append -22