Wiki Lap Inguinal Hernia and Umbilical Hernia same cut

[jabwagner57@verizon.net]

Hi, my doctors are documented a supraumbilical incision dissected down to the umbilical ligament. The camera was introduced thru this incision to complete the Inguinal Hernia repair. In the closing, mention of the Umbilical Hernia repair. I don't think this can be seperetely billed or justified 22 modifier. Any help, info would be appreciated.
Thanks,
Judy

 

[nsteinhauser]

Hi Judy,
Sorry so late to answer. Bring up the NCCI policy Manual online. Go to chapter VI (abdominal), go to section E, #4 to see below:

4. If a hernia repair is performed at the site of an incision for an open or laparoscopic abdominal procedure, the hernia repair (e.g., CPT codes 49560-49566, 49652-49657) is not separately reportable. The hernia repair is separately reportable if it is performed at a site other than the incision and is medically reasonable and necessary. An incidental hernia repair shall not be reported separately.

Of course not all payers follow NCCI but I do.
Hope this helps.