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Thread: Lap Chole and Ventral Hernia

  1. #1
    Join Date
    Apr 2007

    Default Lap Chole and Ventral Hernia

    AAPC: Back to School
    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?

  2. #2
    Join Date
    Apr 2007
    Chicopee, MA


    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.


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