Code Search - Enhanced Code Lookup, CPT® to ICD-10-CM, ICD-10-CM Bridges to ICD-9-CM. Learn more!

Regular Price: $24.95

Ask an Expert Starting at $24.95

Have a medical coding question? Get definitive answers from TCI SuperCoder's Ask an Expert.

Browse Past Questions By Specialty

+View all
Linda Posted 6 Year(s) ago

Would you code for an incisional hernia also based on the closure documentation below?

The peritoneum was closed with running suture of 3-0 Vicryl to the
umbilicus and then attention directed to repair of the incisional
hernia. Because of the open bowel operation, no mesh was used in
this repair. Then the fascia was closed, beginning above the
incisional hernia which required extending the incision to the
epigastrium which was the upper limit of the hernia. The fascia
was closed with interrupted figure-of-eight sutures. Before hernia
repair could be undertaken, an extensive adhesiolysis had to be
performed to clear the anterior abdominal wall from bowel attachment.
This was done with sharp dissection. After the bowel was safely
out of the way, the fascia was closed with interrupted figure-of-eight
sutures of #1 Ethibond. These were placed initially without
securing them until we ensured that we were able to get good closure
of the entire fascia. Figure-to-eight sutures were then secured
with good fascial closure and closure of the hernia defect.

SuperCoder Posted 6 Year(s) ago

Yes I will go for it.An incision is made over the fascial defect. The peritoneal cavity is entered and the sac is dissected free{After the bowel was safely out of the way} from the nearby tissues. The sac is then reduced which is threaded between the muscles and sutured. Finally, the incision is closed with sutures for healing.

Linda Posted 6 Year(s) ago

The closure itself is from a colectomy.
Would that make a difference with interpreting
this properly?

Maarit Posted 6 Year(s) ago

I believe if the hernia was repaired through the same incision made for the colectomy, then you would not bill for it. Here however the surgeon had to extend the incision to epigastrium, so we are in a different location now, and the hernia repair can be coded.

SuperCoder Posted 6 Year(s) ago

Yes this changes the scenario a bit. The closure comes from colectomy only ,hence incisional hernia repair will be coded separately with a 59 modifier..Code 49560 is a column 2 code for colectomy procedures but a modifier is allowed in order to differentiate between the services provided.The last lines "Figure-to-eight sutures were then secured with good fascial closure and closure of the hernia defect." making me understand the closure of hernia defect also along with the colostomy closure.

Posted by Linda, 6 Year(s). There are 5 posts. The latest reply is from SuperCoder.

Related Topics