Nurse Said Something Strange About The Hernia Repair

[Cyndie B 17]

So, I was chatting with the nurse and she said that when the band is put on this actually repairs the hernia and that it is really not two separate procedures. Has anyone ever heard of this? I thought to myself, "well, if that is the case then why am I being charged for two different procedures?" lol. Insurance is paying for the hernia repair and I am coughing up the difference for the lapband so if that is the case then why not accept what the insurance pays?

[jenlyn122 9]

Hmm..my insurance also paid for hernia but not lapband. I assumed that the were two procedures and that they charged the insurance for anesthesia and other stuff and piggy backed the lap band and that's why it is less. If it is all one procedure than that does suck!

[screeden 21]

i think they have to classify it as 2 procedures, insurance makes them do that. it is two procedures, just done at the same time so you don't have to be opened again. insurance companies are money whores who want you to pay them but don't want to pay for things you need.

[Lollicatt 36]

I don't think the lapband literally corrects the hernia. I got before and after pics of it and there is definately cutting and stitching done on mine. They were also done at the same time but billed separately.

[Scooterbug 13]

The Lapband and the hernia repair are 2 seperate procedures. Unfortunatly slapping on the lapband does not automatically repair the hernia because the area of the herniation has to be sutured.

As far as coding, billers have to apply the code for the Lapband AND the hernia repair. Some procedures are "ALL IN ONE" codes..meaning there may be mulitiple procedures done that are listed as 1 code. As of yet there is no 1 code that will cover the Lapband with hernia repair, so you will see 2 seperate charges for the procedures.

There are a few videos on Youtube that actually shows the repair of a hernia in the same session a doctor is doing a Lapband procedure. The videos are not for the squeemish, but will show you exactly that there are 2 seperate procedures to reapir the hernia and apply the Lapband.

Was this nurse a person who actually assisted the doctor in the procedure or worked in the doctor's office??

[Gary Smithey 0]

Aspiring evangelist, did you say "money whores?"

The typical profits for health insurance companies have ranged from 2.2 to 4.4% in 2 of the last 3 years. Tupperware's stock has been reported as a better investment. But you know that they companies are, well I won't say it again.

If anyone believes that the health insurance companies are making killer profits, this will be your lucky day. Beg, borrow or steal to get something in your brokerage account and buy some of their stock!! This is America! You can get rich getting in on this hugely profitable industry (tongue in cheek).

As to the procedures, of course they are two different procedures with different codes being used. My dr. said he wanted me to wait and lose 50lbs before I had the hernia repair.