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Wiki I need help with hernia questions

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4
Location
Joliet, IL
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Can a spigelian hernia found during a robitic bilateral inguinal hernia repair be billed separately? There is not a separate incision the same mesh is used in the repair, the spigelian/ventral hernia is repaired during the planned 49650/50. Can the spigelian be billed/ paid? Should a 59 modifier be used? Or would it be inclusive like an umbilical hernia during the same procedure?
 
Yes, the codes for anterior abdominal hernia repairs changed in 2023. For professional billing, I do have to put a 59 modifier on the second procedure if an inguinal hernia repair is done at the same time - but only if it is a commercial insurance carrier, not for Medicare.
 
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