Results 1 to 2 of 2

Gastric Banding and Hernia Repair combined

  1. #1
    Default Gastric Banding and Hernia Repair combined
    Medical Coding Books
    I have sent this by private message to a couple of people, but I'd like to run it past the group. I have an ASC in our facility. We also have a physician who performs Lap Gastric Bandings for obesity. Most insurances seem to have a contract exclusion for obesity, so patients pay cash for these procedures. The doctor has lately started repairing Diaphragmatic hernias (553.3) while in performing the band. I'm wondering what kind of billing should take place? We've been billing the patient directly for the lap band, but now the doctor is trying to provide another anesthesia code and lap repair codes for the hernia along with dx 553.3. It seems to me that an insurance with an exclusion for obesity wouldn't want to pay for the hernia repair if it was incidental to the obesity I incorrect? Should we be billing the patient for all elements of the surgery? Billing the insurance for all elements? or just billing the hernia to insurance and the lap band to the patient?
    Thank you,

  2. Default
    My doc, on cash patients is still providing the repair but we are not billing out the repair to the insurance company. We eat that piece. But, on the insurance lap band patients we bill the whole thing and are being reimbursed for the secondary procedure. We are getting paid by the way by a few payors for the lap band, but finding just as many exclusions as you seem to be finding.

Similar Threads

  1. Replies: 3
    Last Post: 05-10-2012, 07:08 AM
  2. Lap gastric band placement w/ hiatal hernia repair
    By Leanne in forum General Surgery
    Replies: 3
    Last Post: 11-09-2011, 09:46 AM
  3. Laparoscopic gastric banding w/hiatal hernia repair
    By kandigrl79 in forum General Surgery
    Replies: 2
    Last Post: 06-08-2011, 02:54 PM
  4. Hernia Repair Combined?
    By GuzmanS in forum General Surgery
    Replies: 1
    Last Post: 07-09-2010, 01:27 PM
  5. laparoscopic gastric banding with hiatel hernia repair
    By buppkl in forum General Surgery
    Replies: 0
    Last Post: 05-21-2009, 06:14 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.