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Thread: umbilical herina vs ventral herina

  1. #1
    Join Date
    Apr 2007

    Default umbilical herina vs ventral herina

    AAPC: Back to School
    Hey fellow coders , I keep looking at this operative report and I want to code it as a ventral herina as 49565 with 49568 but booking was 49585 -umbilical herina. ,and when doc states the incision was made above the umbilicusI tendto want to codeit as 49585. Any feedback on this ,what do you think ?

    PREOPERATIVE DIAGNOSIS: Recurrent ventral hernia.

    POSTOPERATIVE DIAGNOSIS: Recurrent ventral hernia.

    PROCEDURE PERFORMED: Repair of recurrent ventral hernia with mesh.

    CLINICAL HISTORY: A 49-year-old male with a recurrent ventral hernia in the area of the umbilicus in need of repair.

    PROCEDURE IN DETAIL: The patient was brought into the operating room and placed on the operating room table in a supine position. The abdomen was prepped and draped in a sterile fashion. A curvilinear incision was made just above the umbilicus through the previous incision. Electrocautery was used to dissect through the subcutaneous tissue down to the fascia. The hernia was entered. It contained omental fat. This was reduced into the abdomen. The hernia sac was dissected away. The resultant defect was approximately 2 x 2 cm. There were no underlying adhesions and Ethicon Proceed hernia system with wings was placed under the defect. It was flat against the fascia. The wings were secured medially and laterally to the fascia with #0 Ethibond suture. Two additional #0 Ethibond sutures were used to secure the mesh to the abdominal wall superiorly and inferiorly. Repair was inspected and found to be excellent. The wound was irrigated with normal saline. The umbilicus was tacked down with a single 3-0 Vicryl. Interrupted 3-0 Vicryl was used to re-approximate the subcutaneous tissue and interrupted 3-0 nylon was used to close the skin. 10 cc of local anesthesia were injected at the end of the procedure into the subcutaneous tissue around the incision.

  2. #2
    Join Date
    Apr 2007


    found answer, docsays ventral-thanks though

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