Abdominal Hernia Repairs – Measuring Defect Length for CPT Coding

Among other things, accurate CPT coding for repair of anterior abdominal hernia requires documentation of the total defect length. When multiple hernia defects are repaired during the same operative episode, calculation of the total defect length requires more than just adding together the length of each defect.

Please watch this presentation to learn about measuring the total defect length for abdominal hernia repairs.

Take Aways

• CPT codes for repair of anterior abdominal hernias include repair of all types of abdominal hernias and repair by any method of approach
• CPT has separate codes for repair of anterior abdominal hernias designated as initial or recurrent
• CPT has separate codes for repair of anterior abdominal hernias designated as reducible or incarcerated/strangulated
• Report a single code based on the total defect size for one or more anterior abdominal hernias, measured as the maximal craniocaudal or transverse distance between the outer margins of all defects repaired.
• Total length of defect(s) corresponds to the maximum width or height of an oval drawn to encircle the outer perimeter of all repaired defects.
• Exception - For defects separated by greater than or equal to 10 cm of intact fascia, the total length of defect is the sum of the lengths of the individual defects.

To find additional instruction in ICD-10-PCS Coding for insertion of central venous access devices, explore the course Hernia Repair Coding in ICD-10-PCS at HIAlearn.com.

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The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.