Is it Ventral, Epigastric or Umbilical?
It is common for the surgeon to submit the following documentation in the op report about a hernia repair to his office staff: 1. Preoperative diagnosis: Epigastric hernia 2. Postoperative diagnosis: Epigastric hernia 3. Procedure: Repair of ventral hernia with insertion of marlex mesh For the surgeon, there is no conflict between the pre- and postoperative diagnoses and the procedure because, clinically speaking, a ventral hernia is defined as any hernia of the abdominal wall other than one that is inguinal or femoral. Using this definition, the procedure qualifies as a ventral hernia, even though the documentation for both pre- and postop diagnoses clearly states otherwise. (For more information on hernia, see box on page 27.) But for billing, such a report poses significant problems for the coder, beginning with the fact that CPT 1999 specifically differentiates among a number of herniae repair that could clinically be defined as ventral, listing more than 20 specific abdominal wall
