Question: Our physician performed a hernia repair on one side and an exploration on the other, but found no hernia. Should we code a second hernia repair with modifier -52, or report an exploration code?
New York Subscriber
ICD-9 code V71.89 (observation for other specified condition not found) should be linked to the appropriate hernia procedure code, Mueller says, noting that this V code is a payable diagnosis.
An exploration code, such as 49000 (exploratory laparotomy, exploratory celiotomy with or without biopsy[s] [separate procedure]), should not be billed because the surgeon does not usually perform work within the peritoneum.