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Initial vs recurrent ventral hernia

E. maria Posted Fri 29th of January, 2016 02:00:05 AM

Patient had an abdominal aortic aneurysm ruptured and underwent endovascular repair by another M.D. Postoperatively, he required a decompression laparotomy due to abdominal compartment syndrome. Multiple washouts with VAC for temporary abdominal closure. Now 10 days later, he underwent bilateral posterior component separations and removal of a previous placed mesh for a ventral hernia repair (mesh had been exposed for 10 days)this left a large defect in that this was essentially a ventral incisional hernia which was repaired with mesh. My questions is for coding, is this considered an initial hernia or is this now considered a recurrent incisional hernia?

SuperCoder Answered Mon 01st of February, 2016 01:51:12 AM

This is a unique case. As per the documentation provided, it seems that hernia repair was revised which was medically necessary along with the primary procedure. CPT codes do not have any code for revision of hernia repair. SO in this case, report it with recurrent incisional hernia repair and bill for mesh as well. To override the bundling issues, report the hernia repair code with -59 modifier.

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