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Surgical Coding: Heed These Hernia Bundling Rules Did you factor in a foreign body removal code by any chance? Question: During an open hernia repair for a reducible umbilical hernia, the surgeon detects a sizeable gallstone embedded in the omentum extending into the preperitoneal fat and he excises the gallstome granuloma with cautery. Patient history shows cholecystectomy eight years ago. So what are the right ICD-9 and CPT codes? Answer: The right procedure code for this scenario is 49585 (Repair umbilical hernia, age 5 years or older; reducible). If the gallstone resection represents a significant amount of extra time and effort, modifier 22 would be apt. Watch out: You shouldn't go for the omentum gallstone resection (49255, Omentectomy, epiploectomy, resection of omentum [separate procedure]) in addition to the 49585 hernia repair. As a designated ‘separate procedure' code, you should list only 49255 if it is the only procedure the surgeon carries out at the site. As you indicate that the gallstone is imbedded in the omentum and extends only partially into the peritoneum, you shouldn't code the service as a peritoneal foreign body removal (49402, Removal...more
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Don't hold back – Cry if you must At one time in my life when I really found it difficult to cry and just kept on going even at times when I felt like having a good cry. It is natural to cry, babies cry because of hunger or any unpleasant feeling and as adults we should also cry.Well nowadays I know that crying does not mean that you are weak. Crying for me is a way of realising the emotional pain I sometimes feel when I face challenges and have tried everything I can to resolve a situation, but I just seem to hit a brick wall. It is also a way of realising stress and tension.Sometimes, I cry so much that there are no longer any tears to be shed.Other times I cry so much that my tears of sadness becomes tears of laughter – when this happens I know that I am on the road to recovery and feeling better.I now have a policy that I can cry as much as I want in a day, but before I go to sleep at night, I encourage and motivate myself to laugh knowing that tomorrow will be a better day.Crying does not have to be just when you feel sad, you can also cry when you feel overwhelmed in a good situation for example:I cried with joy when my children where bornWhen I go...more
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