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Wiki Lap Inguinal Hernia and Umbilical Hernia same cut

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jabwagner57@verizon.net

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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
 
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.
 
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