General Surgery Coding Alert
Check Hernia Bundling Rules
Question: Our surgeon documented an open cholecystectomy and repair of an incarcerated umbilical hernia for a 40-year-old male. Can we separately bill both procedures?
Kentucky Subscriber
Answer: You probably can’t bill both procedures, but the final answer depends on how the surgeon performed and documented the case.
The two codes in question in this case are as follows:
You should code the case as 47600. You should not additionally report 49587 if the surgeon repaired the umbilical hernia through the same incision as the cholecystectomy. In such a case, the hernia repair is included as a necessary component of the cholecystectomy.
On the other hand, if the hernia repair is unrelated to the cholecystectomy — that is, the surgeon made a separate incision to repair the hernia — you may list 49587 in addition to 47600.
Caution: Because there is a Correct Coding Initiative edit bundling 49587 as a column 2 code to 47600, you’ll need to append modifier 59 (Distinct procedural service) to 49587 to indicate that the procedure was separate and distinct from the cholecystectomy
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