Question

PREOPERATIVE DIAGNOSIS: Left inguinal hernia. POSTOPERATIVE DIAGNOSIS: Large left inguinal hernia, direct. PROCEDURE: Repair of large direct left inguinal hernia with Prolene Hernia System Mesh (PHS) and resection of lipoma of the spermatic cord. FINDINGS: Large direct left inguinal hernia and large lipoma of the spermatic cord. DESCRIPTION OF PROCEDURE: After routine preparation, the patient was prepped and draped under general anesthesia in supine position. The bladder was decompressed with a Foley catheter. An incision was made in the left groin parallel to the left inguinal ligament after the skin had been infiltrated with 0.5% plain Marcaine. Subcu was incised. Superficial epigastric vessels were identified, clamped, transected and ligated with 2-0 Vicryl. Scarpa’s was incised. The external oblique aponeurosis was identified and incised. The incision was carried down to the external ring superior to the internal ring. The ilioinguinal nerve was identified, freed from the surrounding tissues and retracted medially. The cord structures were encircled with a Penrose drain. A large lipoma of the left spermatic cord was dissected off all the way to the base, clamped, transected, and ligated with 2-0 Vicryl. The cremasteric muscles were transected at the anteromedial aspect of the cord structures. A hernia sac was identified, which was a small indirect hernia. The sac was dissected all the way to the level of the preperitoneal fat. The contents were mobilized. Then, there was a large bulge in the direct space, almost occupying the entire direct space. It was dissected from the surrounding tissues. Deep epigastric vessels were identified. The fascia was transected. Deep epigastric vessels were skeletonized and retracted cephalad anteriorly. The transversalis was transected circumferentially. The direct space was bluntly dissected until completely dissecting the direct and indirect space. A Prolene Hernia System mesh was placed. The innerlay was unfolded inferiorly, superiorly, medially and laterally. The transversalis was closed over it with 2-0 Vicryl. The overlay was unfolded and sutured to the pubic tubercle inferiorly, cut at the 1 ’o’clock location, wrapped around the cord structures and placed over the internal oblique muscle. The wound was irrigated. Cord structures were placed in the usual anatomic location. The external oblique aponeurosis was closed with 3-0 Vicryl. The external oblique aponeurosis was closed with 3-0 Vicryl. Subcu was closed with interrupted 4-0 Monocryl. Each layer was infiltrated with 0.5% plain Marcaine. The skin was closed with subcuticular 4-0 Monocryl. Dermabond was applied. The patient tolerated the procedure well under general anesthesia and left the operating room to Recovery in good condition.

What are the 2 ICD-10-PCS codes?

What are the root operations?

Answer 1

ICD-10-PCS.

0YU60JZ-

This code explains the procedure of supplement left Inguinal region with synthetic,substitute open approach.

Root operation.

Supplement is the root operation.

00BY0ZZ.

This code explains the procedure of Excision of Lumber Spinal Cord,open approach.

Root operation.

Excision is the root operation.