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Umbilical hernia

E. maria Posted Wed 06th of May, 2015 00:44:43 AM

Patient underwent excision of infected umbilicus 16 cm with layer closure and repair of umbilical hernia. Can we bill for the umbilical hernia repair 49585 and excision and repair of the ulcerated redundant umbilicus skin with ulceration and cellulitis 11406 + 12035?. Report reads a 16 cm elliptical incision was made to excise the entire umbilicus. Dissection was carried through the subcutaneous tissues and the skin was excised from the underlying fascia using electrocautery. The entire umbilicus with surrounding ulcerative cellulitis was excised. A 3 cm umbilical fascial defect was noted. A piece of AlloMax biologic mesh was sewn in place in an underlay faschion. The fascial was closed. A separate piece of AlloMax was then placed over the top of the repair and sutured in place. Subcutaneous tissue was closed.

SuperCoder Answered Wed 06th of May, 2015 04:45:46 AM

Well, codes seems appropriate as per the medical report, but code 12035 is a column 2 code for 49585 , for which 59 modifier is allowed in order to differentiate between the services provided, so use modifier 59 with code 12035 as per CCI edit rule.

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