Me and co-worker having a discussion in what is best for this scnerrio, we can’t find a code for diastasis closure, not sure if we should use unlisted code or append modifier 22 for provider to get credit. Any thoughts on what is best here… or should closure of diastasis be included in the hernia repair..

49585 -22 or
49585/unlisted code (if so, what amount) OR
49585 by itself

PREOPERATIVE DIAGNOSIS: Pre-Op Diagnosis Codes:
* Ventral hernia with obstruction [K43.6]
POSTOPERATIVE DIAGNOSIS: Post-Op Diagnosis Codes:
* Ventral hernia with obstruction [K43.6]
*
PROCEDURE/SURGERY: Repair of umbilical hernia and small periumbilical diastasis
*
*
ANESTHESIOLOGIST: Anesthesiologist: xxxxxx
ANESTHESIA TYPE: General
*
ESTIMATED BLOOD LOSS: minimal
*
COMPLICATIONS: none
*
FINDINGS: small diastasis andumbilical hernia
*
SPECIMENS: none
*
INDICATIONS FOR SURGERY:bulge and pain
*
SUMMARY OF PROCEDURE:
Patient was placed in the operating table in the supine position. General anesthesia was administered. The abdomen was prepped and draped in the usual fashion. A periumbilical midline incision was made and the hernia was identified. The hernia sac was clearly dissected. The hernia sac was reduced inside and the fascia was closed over with a running ethibond suture. After closure of the fascia, the small diastasis was closed with interrupted ethibond. the subcutaneous tissue was dissected one by four mesh was fashioned and placed over the fascial closure and anchored circumferentially to the fascia with interrupted vicryl. The area was then irrigated with antibiotic solution. . After obtaing hemostasis , the subcutaneous tissue was closed with 3- 0 vucryl and subcuticular monocryl for skin Sterile dressings were applied. Firm pressure dressings placed. Final sponge , needle and instrument count was correct.

PREOPERATIVE DIAGNOSIS: Pre-Op Diagnosis Codes:
* Ventral hernia with obstruction [K43.6]
POSTOPERATIVE DIAGNOSIS: Post-Op Diagnosis Codes:
* Ventral hernia with obstruction [K43.6]
*
PROCEDURE/SURGERY: Repair of umbilical hernia and small periumbilical diastasis

*
ANESTHESIOLOGIST: Anesthesiologist: xxxxxx
ANESTHESIA TYPE: General
*
ESTIMATED BLOOD LOSS: minimal
*
COMPLICATIONS: none
*
FINDINGS: small diastasis andumbilical hernia
*
SPECIMENS: none
*
INDICATIONS FOR SURGERY:bulge and pain
*
SUMMARY OF PROCEDURE:
Patient was placed in the operating table in the supine position. General anesthesia was administered. The abdomen was prepped and draped in the usual fashion. A periumbilical midline incision was made and the hernia was identified. The hernia sac was clearly dissected. The hernia sac was reduced inside and the fascia was closed over with a running ethibond suture. After closure of the fascia, the small diastasis was closed with interrupted ethibond. the subcutaneous tissue was dissected one by four mesh was fashioned and placed over the fascial closure and anchored circumferentially to the fascia with interrupted vicryl. The area was then irrigated with antibiotic solution. . After obtaing hemostasis , the subcutaneous tissue was closed with 3- 0 vucryl and subcuticular monocryl for skin Sterile dressings were applied. Firm pressure dressings placed. Final sponge , needle and instrument count was correct.