Lap Chole and Ventral Hernia

N70QW

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Our surgeon does a lap chole and uses one of the port incisions to also repair a ventral hernia. Can we bill for the ventral hernia or does it need to be a separate incision? Using Modifiers?
 

Erica1217

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That's kind of a tough one - because there still is no code for a lap ventral hernia repair you can't actually check CCI.

However, the open ventral hernia code IS bundled into this; this leads me to believe that if there was a code for lap ventral, it would also be considered bundled.

In addition, the Correct Coding Manual says "When, in the course of an open abdominal procedure, a hernia repair is performed, a service is reported only if the hernia repair is medically necessary at a different incisional site."

Although this is regarding "open" codes, I believe the same concept would apply to the lap codes.

I probably wouldn't code it separately.

On the other hand, if the ventral hernia repair was difficult and added a significant amount of extra effort and/or time to the lap chole procedure, you could always try billing it with a modifier -22.

:) Erica
 
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