Hernia Repair

aprillerowland

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If my dr did an open reduced hernia repair (49560) and a partial omentectomy, is that included or would I bill separate for it- which would be (49255)? In the cpt book, it states the omentectomy is a separate procedure but other reading material says its bundled. Can someone clarify for me?
thanks!
 
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"Separate Procedure" is defined as "minor procedures that when done by themselves are coded as a procedure, but when performed at the same time as a major procedure are considered incidental and not coded separately." If there is a major procedure coded, the separate procedure will always bundle and no modifier could break that bundle. This refers to procedures in the same site or location or area for example.

If the major procedure is not related to the minor "separate procedure", then both could be billed. Off the top of my head, using code 61312 Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural is a major procedure, but a partial omentectomy is clearly not related to that, so both could billed. (The likelihood of this ever happening is zero, but hopefully you get the idea)

In your case, only the hernia repair could be billed.
 
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