it is possible to bill the access(umbilicus) when repairing an inguinal hernia?

rceron

Contributor
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Hi,
my doctor asked me yesterday, if it was possible to billed the access (contralateral) thru the umbilicus in order to repair an inguinal hernia based on the different anatomic site incision rule. i am not quite sure if this rule would apply in this scenario..
 

Lujanwj

Guru
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Can't code for the closure (unless there's a flap or overriding guidelines). Dr has to repair the port site regardless of where it is (existing hernia or by incision). Surgical Closure is considered an integral component of a procedure.

NCCI Policy Manual:

B. Coding Based on Standards of Medical/Surgical Practice

Services integral to HCPCS/CPT code defined procedures are included in those procedures based on the standards of medical/surgical practice. It is inappropriate to separately report services that are integral to another procedure with that procedure.
 
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