I'm not getting a bundling edit for 57425 and 57240, would it be appropriate to bill both together? Thank you in advance.
DESCRIPTION OF PROCEDURE IN DETAIL:The patient was taken to the operating room where a general anesthetic was administered. She was prepped and draped in sterile fashion. A Veress needle was inserted through the umbilicus. The abdomen was insufflated. An Optiview trocar was inserted. Two left lateral ports and 2 right lateral ports were placed under direct visualization.
Adhesions were taken down and the vaginal apex was identified.
A vaginal manipulator was placed against the anterior wall to define the patient's large cystocele. The peritoneum and bladder were dissected away so that the anterior vaginal fascia could be plicated with several interrupted sutures, thereby restoring the integrity and natural length of the anterior vaginal wall.
The peritoneum and bladder were dissected away from the vaginal apex sufficiently to permit attachment of a polypropylene Y mesh with multiple Gore-Tex sutures that were tied extracorporeally. The peritoneum over the sacral promontory was then opened and this incision was carried down into the posterior cul-de-sac. The upper end of the mesh was attached to the presacral ligaments in the S1 region with 2 Ethibond sutures that were also tied extracorporeally. The mesh was then trimmed and the peritoneum was closed over the mesh with a running suture, thereby burying it in the retroperitoneum. A survey of the abdomen was carried out. There was no evidence of any complication and the patient was hemostatic. Insufflation was released. Ports were removed and the port incisions were closed.
A cystoscopy was performed and there was no injury to the bladder. Vigorous jets were observed from both ureters.
DESCRIPTION OF PROCEDURE IN DETAIL:The patient was taken to the operating room where a general anesthetic was administered. She was prepped and draped in sterile fashion. A Veress needle was inserted through the umbilicus. The abdomen was insufflated. An Optiview trocar was inserted. Two left lateral ports and 2 right lateral ports were placed under direct visualization.
Adhesions were taken down and the vaginal apex was identified.
A vaginal manipulator was placed against the anterior wall to define the patient's large cystocele. The peritoneum and bladder were dissected away so that the anterior vaginal fascia could be plicated with several interrupted sutures, thereby restoring the integrity and natural length of the anterior vaginal wall.
The peritoneum and bladder were dissected away from the vaginal apex sufficiently to permit attachment of a polypropylene Y mesh with multiple Gore-Tex sutures that were tied extracorporeally. The peritoneum over the sacral promontory was then opened and this incision was carried down into the posterior cul-de-sac. The upper end of the mesh was attached to the presacral ligaments in the S1 region with 2 Ethibond sutures that were also tied extracorporeally. The mesh was then trimmed and the peritoneum was closed over the mesh with a running suture, thereby burying it in the retroperitoneum. A survey of the abdomen was carried out. There was no evidence of any complication and the patient was hemostatic. Insufflation was released. Ports were removed and the port incisions were closed.
A cystoscopy was performed and there was no injury to the bladder. Vigorous jets were observed from both ureters.