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tci Outpatient Facility Coding Alert - 2012 Issue 6

Reader Question: Initial vs. Recurrent Steers Inguinal Hernia Coding

Question: The surgeon performed laparoscopic preperitoneal repair of an incarcerated left inguinal hernia. He used mesh polypropylene insertion. What is the correct code? Answer: There is no code for laparoscopic repair of an incarcerated inguinal hernia. Your best choices are 49650 (Laparoscopy, surgical; repair initial inguinal hernia) or 49651 (... repair recurrent inguinal hernia), depending on whether the hernia is initial or recurrent. You might be able to append modifier 22 (Increased procedural services) if the repair was difficult because the hernia was incarcerated. Documentation would need to support the modifier usage. ...

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