Wiki Umbilical Hernia

[coderguy1939]

Doctor did an open umbilical hernia repair. There was one incision with multiple sac/defects that were repaired separately and covered with one piece of mesh. I'm looking at 49585. Does anyone have any info on reporting this more than once under this scenario. Input would be appreciated.

 

[mikereyland]

I would not report it more than once, rather add a 22 modifier and have your Doc clearly state the amount of excess op-time as well as the amount of defects repaired. If the insurance company does not up the allowable then send the op-note and a letter requesting an additional payment (ex. 25%)based on the situation.

Michael D. Reyland, CPC, CIRCC
Surgical Specialists of Georgia

 

[coderguy1939]

Thanks, Michael. Appreciate your response.