Anesthesia Coding Alert
Surgical Site Determines 'Upper' or 'Lower' Abdomen Anesthesia
Question: Can you provide an example for knowing which area is upper abdominal and which is lower, for colectomy or incisional hernia repair?
Florida Subscriber
Answer: The dividing line between upper and lower is the belly button (or umbilicus). The problem is that many times physicians document "midline incision," which doesn’t always give the information needed for coding.
Remember this: The site of incision doesn’t matter. Instead, focus on where the work is performed. To answer your question about the colectomy, the colon is considered upper (unless work is exclusively on sigmoid or rectum). For procedures such as incisional hernia repair, check the chart for details regarding the hernia location to choose between codes such as 00750 (Anesthesia for hernia repairs in upper abdomen; not otherwise specified) and 00830 (Anesthesia for hernia repairs in lower abdomen; not otherwise specified).
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