I don't think the op note quantifies an open procedure. I'm basing my opinion on "..the excision was extended somewhat..." and "...followed under direct vision with the laparoscope..." It sounds like the incision was extended to aide in trocar insertion, but the surgical procedures were accomplished with laparscopic assistance. Plus the closing sounds like a normal laparoscopic closing and not the closing of an open procedure. That's just my interpretation of the above note, though, for whatever it's worth. Hope it helps.
Rebecca Hardin, CPC
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