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AHA Coding Clinic® for HCPCS - 2020 Issue 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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