General Surgery Coding Alert

Question: I read your You Be the Coder about a hernia repair and bowel repair in the Vol. 12, No. 8 issue. Is the reason for not billing both the right inguinal incarcerated hernia and ischemic  bowel because the documentation doesn't state the bowel was strangulated/ incarcerated in the hernia? Per CPT guidelines "the excision/ repair of strangulated organs or structures such as testicle(s), intestine, ovaries are reported by using the appropriate code for the excision/repair (e.g., 44120, 54520, and 58940) in addition to the appropriate code for the repair of the strangulated hernia." Florida SubscriberAnswer: Although CPT allows separate billing for excision or repair of organs damaged due to incarceration, most payers will not pay for this separately. The logic is that the provider would have had to repair the abdominal wall as part of the excision or repair and therefore this doesn't represent enough separate work to allow separate [...]