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Thread: Crazy over hernias

  1. #1

    Default Crazy over hernias

    AAPC: Back to School
    I'm really needing clarification on this. A surgeon peformed a lap cholecystectomy upon making the umbilical incision a small umbilical hernia is discovered. The hernia is enlarged & the trocar is inserted, the gallbladder is removed & the incision is closed. Is the umbilical hernia considered part of the lap chole since the same incision is used for both & the closure of the umbilical incision repairs the hernia & closes the incision for the lap chole? I'm going crazy with finding out the right direction to go in and could really use some help. I need to talk to the surgeon if the hernia is considered incidental to the lap chole. From previous post's I know they are not bundled but not clear on how to go about this. I had asked a contracted service & they stated it was incidental in that the surgeon just enlarged the hernia and used it for a port site for the lap chole. I'm interested to know if others agree. Thank you!

  2. #2
    Join Date
    Apr 2007
    Vancouver Washington


    it is my understanding that if the doc repairs a hernia upon enterance or during the closure it is included...not separately reportable.

    hope this helps

    Jaime Wicklund, CPC

  3. #3
    Join Date
    Apr 2007
    Bangor, Maine


    I agree. It is incidental. If documentation supports, maybe a -22 can be used along with a copy of the op report?

  4. #4
    Join Date
    Apr 2007
    Kansas City, MO


    Quote Originally Posted by jaimewicklund View Post
    it is my understanding that if the doc repairs a hernia upon enterance or during the closure it is included...not separately reportable.

    hope this helps


    Agree...same incision=it's inclusive.
    Linda Vargas, CPC, CPCO, CPMA, CPC-I, CEMC
    PMCC Licensed Instructor
    Kansas City, MO Chapter
    Member Development Officer 2016
    Harrisonville, MO Chapter President - 2013
    ICD-10 Education Coordinator- 2012
    Chapter President - 2011
    President Elect - 2010

  5. #5


    Yep it's inclusive unless the surgeon made a separate incision to do the service, but if he did it while doing the other procedure to make sure there's no complications later it's inclusive. Its like with lap hiatial hernia repair while doing a lap gastric bypass..it's inclusive.

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