Wiki Vaginal cuff exposure, followed by closure

[steph2355]

I need help coding this op report:

Preop Dx;
1. post total robotic hysterectomy 5 months ago
2. abscessed colonic epiploica
3. possible diverticulitis
4. small vagina cuff dehiscence

proc:
1. Dx Laparoscopy
2. vaginal cuff exposure, followed by closure
3. Cystoscopy

placed in steep postion with the findings noted. Once this was completed we dissected the sigmoid off the vagina cuff with the findings noted. there was noted to be a small abscess in the area. No perforations in the bowel. there was a small rind on that, again difficult to tell if diverticulitis or diverticulosis. Once this was completed vagina sewed the cuff up as described and then we removed of inflamed tissue and then closed the vaginal cuff, resupported it lapraoscopically as described.

I will take any help on this.

 

[csperoni]

My issue is that the op note twice states "as described" without describing.
"Once this was completed vagina sewed the cuff up as described and then we removed of inflamed tissue and then closed the vaginal cuff, resupported it lapraoscopically as described."
I would query the provider. If by resupported it laparoscopically they mean laparoscopic colpopexy, then I would code 57425.
Possible other codes could include:
57423 Paravaginal defect repair, laparoscopic approach
OR
57200 Colporrhaphy, suture of injury of vagina (if cuff was sewed vaginally) AND
49320 Laparoscopy, abdomen, peritoneum, and omentum, diagnostic

My gut says 57425 due to "resupported", but the provider needs to describe and clarify.