mstallings
Guest
I have a surgeon who has performed mulitple surgery's on a patient and as result he now has an abdomen that cannot be closed. The surgeon states he did Planned re-laparotomy, repair of hernia and implantation of mesh.
The op report states :
The abdominal contents were inspected. There was no evidence of contamination. Following this, 6 layers of vicryl mesh were sewn in with running 0 Prolenes. We had to use the 12 x 12 inch sheets of mesh turned on their corenr to cover the wound. Dressing were applied.
Surgeon wants to bill an open abdomen hernia.
When I read NCCI manual it states: 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 is not medically reasonable and necessary and should not be reported separately.
Surgeon states anytime abdomen cannot be closed it is considered a hernia. I am not in agreement. I explained the hernia repair he has to open the abdomen, however the abdomen is already open.
Should I bill a hernia repair with a 52 ?
~ Michelle
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