tci General Surgery Coding Alert - 2008 Issue 12

READER QUESTIONS: Watch Location for Unlisted Hernia Repair

Question: Which code should I report for a laparoscopic paraesophageal hernia repair? The only thing I can find is unlisted procedure code 49659. Arizona Subscriber Answer: Paraesophageal hernia is a severe form of hiatal hernia, which involves migration of the fundus of the stomach and can result in subsequent strangulation of the fundus. You are correct that CPT does not contain a precise code for this procedure. Rather than 49659 (Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy), however, you should instead select 39599 (Unlisted procedure, diaphragm). Here's why: CPT assigns a diaphragm repair code (39502, Repair, paraesophageal hiatus hernia, transabdominal...

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