tci Outpatient Facility Coding Alert - 2014 Issue 1

Reader Question: Coding for Inguinal Hernia Could Be a Breeze

Question: What would be the correct code for the following: left indirect/inguinal hernia was repaired with a mesh plug and repair of indirect hernia of the left side with Gore-Tex suture by approximating the posterior fascia. Is a modifier required in this case?Virginia Subscriber Answer: The hernia repair codes are categorized primarily by the type of hernia (inguinal, femoral, incisional, etc). In this case the appropriate code would be 49505 (Repair initial inguinal hernia, age 5 years or older; reducible), assuming the patient is 5 years of age or older. If the patient is under age 5, you...

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