What evidence do you have to support your coding decision

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Reference no: EM134042474

Assignment:

A patient presents for a repair of a recurrent umbilical hernia. The surgical history portion of the preoperative history and physical document states that the patient has previously undergone repair of this umbilical hernia approximately 3 years ago. The preoperative and postoperative diagnosis state: "recurrent umbilical hernia" As a new coder, you are under a focused audit review. Your auditor states this should be coded as an "incisional hernia." You disagree, and believe it should be coded as an "umbilical hernia."

1. Who is correct?

2. What evidence do you have to support your coding decision?

3. What ICD-10-CM diagnosis code will you assign?

4. Does the diagnostic statement (incisional vs. umbilical type) effect CPT code assignment?

Reference no: EM134042474

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