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Additional procedure chargeable?

  1. Default Additional procedure chargeable?
    Medical Coding Books
    I need to know if the following hernia procedures are billable. When a surgeon performs a laparoscopic procedure, I will use a lap chole for example, and he pulls out the trocar at the end of the procedure and then enlarges that incision and repairs an incisional or ventral hernia, can this repair be billed or would you say it is included in the lap chole since it is the same incision? Previously we have only billed the lap chole due to it being the same incision but now we are questioning this. Any help would be greatly appreciated.

  2. #2
    It will depend on the type of hernia repair. You will need to check all edits for the specific surgery combos but a general rule is that if the hernia repair is necessary as part of the closure of the original procedure then it is generally bundled. An example of this would be a Lap Chole with an umibilical hernia repair. Since your umbilical incision must be closed as part of the Lap Chole closure then your repair would be considered to be part of the closure and therefore not separately billable. Hope that helps!

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