Wiki Lap hernia w open umbilical

[abrinkley812@gmail.com]

Hello everyone,

I am new to surgical coding and unfortunately we do not have a lot of rules to go by here, my doctor is trying to bill a laparoscopic inguinal hernia along with an open umbilcal hernia. I am struggling because it seems as though the umbilical should not be billed due to the lap site. CCI edits say it can go, although I have noticed Anthem is not wanting to pay but this patient is for Aetna. 49650 49585. Thank you for any insight!

 

[nickelclaw]

I would try and add modifier to the umbilical. If pt had two hernias known prior to surgery. (stated in H/P)
If it was say an incidental finding while inserting the scope then I wouldn't code it.
Hope that makes since

 

[abrinkley812@gmail.com]

Yes, thank you!