hagand
Contributor
If you have this scenario, would you code for the incidental hernia through same incision? Or does this fall in with Medicare guidelines that incidental hernia during a major surgery apply? Here is a portion of the op note:
A peritoneal flap was created approximately 7cm from the umbilical defect towards the camera and carried superiorly and inferiorly to accommodate adequate mesh coverage. The flap was developed with a combination of blunt
dissection and electrocautery. At the level of the hernia defect, we dissected circumferentially and then fully reduced the hernia sac. I then also noted a small epigastric hernia with incarcerated preperitoneal fat. This fat was also reduced. Dissection was then carried further laterally to accomidate mesh placement. Hemostasis was confirmed. A ruler was inserted and the umbilical defect was measured to be 2 cm. The additional epigastric defect was approximately 1 cm. The distance between the 2 was about 3 cm making the total hernia defect 5 cm. The pocket was noted to be 15 x 9 cm.
thank you in advance!
A peritoneal flap was created approximately 7cm from the umbilical defect towards the camera and carried superiorly and inferiorly to accommodate adequate mesh coverage. The flap was developed with a combination of blunt
dissection and electrocautery. At the level of the hernia defect, we dissected circumferentially and then fully reduced the hernia sac. I then also noted a small epigastric hernia with incarcerated preperitoneal fat. This fat was also reduced. Dissection was then carried further laterally to accomidate mesh placement. Hemostasis was confirmed. A ruler was inserted and the umbilical defect was measured to be 2 cm. The additional epigastric defect was approximately 1 cm. The distance between the 2 was about 3 cm making the total hernia defect 5 cm. The pocket was noted to be 15 x 9 cm.
thank you in advance!