tci General Surgery Coding Alert - 2023 Issue Q3

Reader Questions: Use Unlisted Codes Appropriately

Question: During a laparoscopic procedure investigating a bulge in the patient’s upper inner thigh, the surgeon identified a femoral hernia containing fatty tissue and reduced the hernia. Should we bill the hernia repair as 49550? Could we use modifier 22 because of the exploratory laparotomy? Oregon Subscriber Answer: No, you should not bill the hernia repair using 49550 (Repair initial femoral hernia, any age reducible), because that code describes an open hernia repair procedure. CPT® does not include a code for laparoscopic femoral hernia repair, so your only choice would be 49659 (Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy)...

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