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Hernia umbilical???

  1. #1
    Default Hernia umbilical???
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    a year ago, had repair of an umbilical hernia. She has a painful scar that has not improved with time. I saw her in the office, and recommended that she have excision of the sutures, as these were palpable and painful to her. As this was in the fascia, we would also have to do hernia repair at the same time. The patient presents at this time for surgery.

    The patient was brought to the operating room, identified, and placed in the supine position on the operating room table. Intravenous access had previously been obtained, following which general anesthesia was induced.

    Following this, we initially made a vertical incision in the umbilicus. The patient had some redundant skin fold in the umbilicus, and this is excised. This was done down to the previous scar. Following this, we dissected the subcutaneous tissue and the scar down to the fascia. Several Nurolon sutures are identified and removed, and after removing a portion of the fascia with this scar. Following this, the fascia was identified on either side, and this was closed with interrupted 0 Vicryl sutures. Following this, the deeper tissue was approximated with 4-0 Monocryl, and the skin was closed

    This would just be an 49585 the suture removal would be included correct??

  2. Default
    is there actually another umbilical hernia? I'd have coded it as an incisional hernia, since the hernia is apparently part of the incision from the previous surgery and there's no provision for recurrent umbilical hernias. Since the suture removal is part of the hernia repair, then yes, it's included.

  3. #3
    Thank you thats were my thoughts were, He referenced the surgery a year ago and that the scar was painful. I don't know why the doc wanted to use umbilical???? Thought I was not seeing something.


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