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CPT for recurrent epigastric hernia

E. maria Posted Mon 13th of July, 2015 14:46:02 PM

Since there is no CPT code for a recurrent epigastric hernia, can this be coded as an incisional hernia?

SuperCoder Answered Tue 14th of July, 2015 00:33:24 AM

Yes you are right, there is no CPT code for recurrent epigastric hernia repair. as if it is recurrent (occurred again after primary reduction, surgically through a incision) yes, you can bill it as incision hernia repair. But if it is reduction of reducible epigastric hernia, bill it with unlisted CPT code.

E. maria Posted Wed 15th of July, 2015 11:58:13 AM

It is a recurrent epigastric hernia. Do I bill CPT code 49560, or 49565?

SuperCoder Answered Thu 16th of July, 2015 00:11:06 AM

If hernia occurred first time after surgical reduction, bill CPT 49560. But if it is occurring frequently at the site of a previous surgical incision bill it with CPT code 49565.

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