General Surgery Coding Alert

Question: The surgeon is doing an open hernia repair through a small incision. He repairs the hernia and then puts in a port using the same incision for a lap chole and repairs this as well. I usually would use the conversion to an open procedure diagnosis code V64.41. But this case isn't a conversion from lap to open, but open to lap. How do I report this type of procedure? Minnesota Subscriber Answer: In this case, you cannot separately report the hernia repair. You can't code for the repair of a hernia (an abdominal wall defect) when your surgeon performs another procedure through the same part of the abdominal wall. Why: The abdominal wall would have required repair once the surgeon completed the other procedure. You could only add modifier 59 (Distinct procedural service) and bill the hernia separately if your surgeon performed the repair at a different site [...]