• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
  • Important Note: We will be performing a scheduled maintenance on 1st November 2020. The site will be offline from 7:30PM (MT) till midnight. We apologize for any inconvenience this may cause.

Hernia/Wound Repair

lkoch829

Guest
Messages
25
Best answers
0
Hi,

We recently did a wound/hernia repair and I recently read that one cannot bill for a hernia repair if it is not done through a separate incision. Where in CCI would I find this information? We repaired an open non-healing wound through debridement and flap closure, but repaired a hernia/fascial defect prior to closure. We don't do a lot of hernia repairs and the CPT book doesn't say anything about this being bundled.

Thanks for your help!
 

Cyndy

Guest
Messages
9
Best answers
0
hernia

The CCI edits Chapter VI-5 Digestive System codes 40000-49999 states
"If a hernia repair is performed at the site of an incision for an open abdominal procedure, the hernia repair is not separately reportable." However "it is separately reportable if it is performed at a site other than the incision and is medically reasonable & necessary. An incidental hernia repair is not medically reasonable and necessary and should not be reported separtely."

Hope that helps.
 

cmartin

Guru
Messages
204
Best answers
0
I'm not sure that a debridement & flap closure would constitute an open abdominal procedure, of the depth required to make a hernia rpr incidental. Would depend on the size & depth of the wound I guess.
C.Martin, CPC-GENSG
 
Top