AHA Coding Clinic® for HCPCS - 2019 Issue 1; Ask the editor

Hybrid hernia repair

Patient presents for hybrid repair of an incisional hernia. The patient is morbidly obese and has undergone past abdominal surgeries. The small bowel was adhered to the abdominal wall due to multiple adhesions. Numerous ports and trocars were placed and the abdomen was explored via camera. Small bowel adhesions surrounding the hernia site were dissected from the abdominal wall. A small incision was made over the hernia site in order to excise the hernia sac which was discarded. No injury was noted to the small bowel. The defect was measured and sutures were placed in the corners of the mesh, and the mesh was placed into the abdominal wall area through the hernia site. Laparoscopically, the mesh was thoroughly secured to the abdominal wall under direct visualization with sutures and an additional device. Our facility wants to know how to correctly report the hybrid hernia repair since an open and laparoscopic technique were used to perform the procedure. We have been advised to report it as an open procedure. ...

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