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Kathy Posted Mon 29th of January, 2018 17:00:08 PM
-If provider performs a laparoscopic bilateral direct inguinal hernia, but there is also a LT femoral component. Can we bill 49650-50 with 49659-LT? -What if they are all incarcerated? -What if inguinal's are reducible, but femoral is incarcerated (or vice versa)? -What if the inguinal hernia's are indirect, rather than direct? Thanks.
SuperCoder Answered Tue 30th of January, 2018 04:27:44 AM

Hi,

1. Yes, you can bill 49650-50 with 49659-LT for laparoscopic bilateral direct inguinal hernia and left femoral hernia.

https://www.supercoder.com/coding-newsletters/my-outpatient-facility-coding-alert/reader-question-theres-no-need-for-49659-when-same-mesh-covers-two-hernias-139499-article

 

2. Codes remains same if they are all incarcerated. CPT 49650 (Laparoscopy, surgical; repair initial inguinal hernia) does not specify whether the hernia repair is for an incarcerated or non-incarcerated hernia, and thus, code 49650 is appropriate for reporting initial inguinal hernia repair, regardless of the type being repaired. If the repair was difficult due to the hernia being incarcerated, perhaps modifier -22 could be added but documentation would be needed to support this modifier. 49659 (Unlisted laparoscopy, procedure, hernioplasty, herniorrhaphy, herniotomy) be reported for incarcerated.

3. Codes will remain same if inguinal hernia's are indirect. Inguinal hernias can be either “direct” or “indirect” , but this is not a factor when coding.

 

Thanks

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