AHA Coding Clinic® for HCPCS - 2020 Quarter 1; Ask the Editor
Multiple hernia repair
The Central Office has received several requests for clarification regarding code assignment for multiple hernia repairs with respect to previously published advice. In Coding Clinic for HCPCS, Fourth Quarter 2010, page 7, both umbilical and ventral hernias were repaired through the same incision and the advice provided indicated separate code assignment for both hernias. However, in the Third Quarter 2016 issue, page 2, inguinal, femoral and obturator hernias were repaired laparoscopically via the same groin incision and the advice was to assign one code to capture the three hernia repairs performed through the same incision. In addition, in Chapter VI, Section E.4. of the National Correct Coding Initiative (NCCI) Policy Manual, it states that if a hernia repair is performed at the site of an incision for an open or laparoscopic abdominal procedure, the hernia repair is not separately reported. Is this applicable to multiple hernia repairs or does this guidance only apply to hernia repairs when performed during a different/separate abdominal procedure? When multiple hernia repairs are repaired through the same incision, is one code or are multiple codes assigned? ...
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Article Overview
This article explains a coding clarification topic involving multiple hernia repairs, with reference to prior published guidance and policy language from coding and compliance resources. It is relevant to coders, auditors, and billing staff who work with hernia procedures and need to understand how different published sources address repairs performed through the same incision or at an incision site. The discussion focuses on how to interpret and reconcile guidance from earlier Coding Clinic material and the NCCI Policy Manual.
Why This Topic Matters
Multiple hernia repair scenarios can raise questions about how to report procedures consistently when more than one hernia is treated in the same operative setting. Understanding the clarification discussed in this article helps support accurate, compliant reporting and reduces the risk of conflicting application of published guidance.
What You Will Learn
- How the article frames a clarification request involving multiple hernia repairs
- Which published coding sources are referenced in the discussion
- What general issue is being examined about procedures performed through the same incision or at an incision site
- How policy guidance is being compared across different coding references
Who Should Read This
- Medical coders
- Coding auditors
- Billing specialists
- Compliance professionals
- Revenue cycle staff
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