# coding of umbilectomy with hernia repair



## mrolf (Jan 7, 2010)

Our surgeon did a umbilectomy and then a umbilical hernia was noted and was repaired.  When billed 49250-umbilectomy and 49585-umbilical hernia repair, Medicare denied the 49250.  Does anyone know how this should have been billed? There was no indication in the CPT that this is a bundled procedure.  Thanks


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## ashikbabu5@gmail.com (Jul 7, 2017)

When checking with CCI edits, it shows CPT 49250 is bundled into CPT 49585. so we can bill with CPT 49585 but a doubt arises as "when performing umbilectomy the complete umbilical cord is removed then what is the use of repairing umbilical hernia" ? - anyone help me that can we bill with CPT 49250 or not.


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## thomas7331 (Jul 7, 2017)

CPT code 49250 has a 'separate procedure' designation in CPT, so it is always incidental and bundled to another procedure in the same anatomical location and should never be billed in addition.  Under NCCI, a modifier cannot be used to override this bundling.


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## CodingKing (Jul 7, 2017)

NCCI Manual States:



> If a hernia repair is performed at the site of an incision for an open or laparoscopic abdominal procedure, the hernia repair (e.g., CPT codes 49560-49566, 49652-49657) is not separately reportable. The hernia repair is separately reportable if it is performed at a site other than the incision and is medically reasonable and necessary. An incidental hernia repair is not medically reasonable and necessary and should not be reported separately.


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