tci General Surgery Coding Alert - 2010 Issue 8

You Be the Coder: Hernia Repair Plus Bowel Resection

Question: A patient had a right inguinal incarcerated hernia. When the doctor dissected the hernia sac, he noticed some ischemic bowel. The doctor documents in the op report "careful dissection of this down to a knuckle of bowel, which was ischemic." Is this incidental to the hernia repair or can I code for the partial small-bowel resection? If not, can I add modifier 22 to the hernia repair for the extra work involved? Missouri SubscriberAnswer: You should actually code the bowel resection instead of the hernia repair in this case. Therefore, you would report a code such as...

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