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Urology Coding Alert

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When Is a Hydrocele Really a Hernia?

Question: I have a case where the patient is diagnosed with a hydrocele and have heard that the procedure code should be a hernia repair code as this is a pediatric patient. I was told that the hernia and a hydrocele are basically the same thing in a pediatric patient. Is this correct? California Subscriber Answer: You are correct. In children there is often a communicating hernia and hydrocele. If the surgical approach is via an inguinal incision to correct the small associated hernia, and then the hydrocele is drained (most often this is the case with children), and the child is over five years of age, code both 49505 (Repair initial inguinal hernia, age 5 years or older; reducible) for the hernia repair and 55040 (Excision of hydrocele; unilateral) for the hydrocele repair.