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recurrent inguinal hernia

  1. #11
    Default mbort
    Medical Coding Books
    Well, that is why I was confused because I didn't think that he should be docked with the -78 if it wasn't something he did wrong in the first surgery. He lets everyone know before hand of the complications and of course that it one. So, I will check with him, he is in surgery today so I will ask him on Friday. If he says it was nothing he did wrong I'll use -79 and if something went wrong with the first surgery then I will use the -78. Does the -79 not reduce his reimbursement but just starts the global over? Thank you for your imput.

  2. #12
    Milwaukee WI
    Default Was the first repair 49520?
    I'm not clear from your original posting ... was the first hernia repair for an initial hernia repair, or was it also a recurrent?

    If the earlier surgery also used CPT 49520, then you could use modifier 76 (repeat procedure).

    Hope that doesn't further confuse you.

    F Tessa Bartels, CPC

  3. Default yes
    79 does start the global over and it does not reduce your remibursement. It dosen't have to be something the dr did in order for it to be related. It's the same hernia, on the same side w/in the 90's related. what code did you use initially?
    adrianne, cpc

  4. #14
    I do not believe that because its the same site (which the initial post indicated that it "could be" inferior to previous site), same side and within the 90 global that it is automatically "related" to the initial surgery.

    I do believe however that there are several and certain conditions (that we are not aware of) that could effect the choice of modifiers used for this case.

    I would still suggest checking with the surgeon to obtain additional information and documentation prior to making your decision on the use of the appropriate modifier.

  5. #15
    On the first surgery I used dx 550.10 with 49507 because it was incarcerated.

    I asked him about the second surgery. He said that the sutures pulled. The lady is 80 and wasn't doing anything strenuous. So, I think I am going with dx 550.91 with 49520-78.

    Thank you for all the help.

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