billable icd 9 code for inguinal repair

Full Answer

How do you code an inguinal hernia repair?

There is a separate, specific code — 49525 Repair inguinal hernia, sliding, any age — for the repair of a reducible, sliding inguinal hernia. If the hernia is incarcerated or strangulated, however, 49525 does not apply. Instead, you would revert to 49496, 49501, 49507, or 49521, as appropriate.

What is the ICD 9 code for hernia repair?

53.9 Other hernia repair - ICD-9-CM Vol.

How do you code hernia repair?

The following CPT codes are used to report hernia repair:49505 – Repair initial inguinal hernia > 5 yrs. ... 49560 – Repair initial incisional or ventral hernia; reducible.49561 – Repair initial incisional or ventral hernia; incarcerated or strangulated.49585 – Repair umbilical hernia, age 5 or older; reducible.More items...•

What is the ICD 10 PCS code for hernia repair?

This directs users to code 53.04, Other and open repair of indirect inguinal hernia with graft or prosthesis. This code indicates the procedure was unilateral but does not specify the laterality further.

What is the ICD code for inguinal hernia?

3 Unilateral or unspecified inguinal hernia, with obstruction, without gangrene.

What is the ICD-10-CM code for inguinal hernia?

ICD-10 Code for Unilateral inguinal hernia, with obstruction, without gangrene- K40. 3- Codify by AAPC.

What is the CPT code for inguinal hernia repair with mesh?

CPT® lists only three codes for laparoscopic hernia repair, including two codes for inguinal hernia repair (49650, any initial repair and 49561, all recurrent repairs) and a single unlisted-procedure code, 49659, to cover laparoscopic repairs of all other hernia types, regardless of patient age or initial/recurrent, ...

How are hernia repairs are often categorized?

In general, hernia surgeries are classified as herniorrhaphy or hernioplasty. Hernia repairs are day surgeries, so people go home a few hours afterward. Hernia surgeries are considered fairly safe and effective.

Is a femoral hernia the same as an inguinal hernia?

A femoral hernia is a bulge in the upper part of the thigh near the groin. Inguinal hernia is the result of an organ, usually bowel, protruding through a weak point or tear in the thin muscular abdominal wall.

What is the root operation for inguinal hernia repair with mesh?

The root operation “Supplement” involves repair of the inguinal hernia with the use of biological or synthetic material, such as a tissue graft or mesh. The tissue graft or synthetic material is used to reinforce or augment the muscles and fascia in the designated body region.

What is the CPT code for repair abdomen?

Repair Procedures on the Abdomen, Peritoneum, and Omentum CPT® Code range 49491- 49659. The Current Procedural Terminology (CPT) code range for Repair Procedures on the Abdomen, Peritoneum, and Omentum 49491-49659 is a medical code set maintained by the American Medical Association.

Is lysis of adhesions included in hernia repair?

Answer: No, 44005 enterolysis (freeing of adhesions) for an open procedure and 44180, laparoscopic enterolysis, are both designated as “separate procedures.” They are considered integral to the primary procedure at the same anatomic site.

What is the CPT code for hernia repair?

It is considered inclusive of the other procedure. The open hernia repair codes are found in the range of codes 49491-49611. The laparoscopic codes are found in the CPT ® range of codes, 49650-49657. CPT ® code 49659, unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy is reported when a CPT ® code does not exist for the type ...

When was the last update in hernia coding?

The last update in hernia coding was in 2009.

What is the CPT code for mesh placement?

If you are new to general surgery coding, read on. Placement of mesh (49568) is an add-on code for incisional or ventral hernia repairs, performed via an open approach. The range of codes that CPT ® code 49568 may be reported with is 49560—49566.

What is abdominal hernia?

An abdominal hernia is a protrusion of part of the intestines through a weakened section of the abdominal cavity; herniations can occur in other parts of the body, such as muscle herniations. This article addresses abdominal hernias. Surgery is directed at permanently closing off the orifice through which the abdominal structures protrude.

Is abdominal surgery a permanent intervention?

Surgery is directed at permanently closing off the orifice through which the abdominal structures protrude. Sometimes, the hernia can be manually reduced, but this is not a permanent intervention. There isn’t a code for medical reduction of a hernia, it is part of an E/M service. Codes in the abdominal repair section of CPT ® (49491—49659) ...

Do you append modifier 50 to a right inguinal hernia?

Do not append a modifier 50 to a right initial inguinal hernia and a recurrent left inguinal hernia, both repaired via the same approach. If either an incisional or ventral hernia repair is done at the time of another abdominal procedure, through the same incision, do not separately report the hernia repair.

What is the code for a hernia?

Grintwig. 49565 is not the correct code to use for an inguinal hernia. The code range for inguinal hernias is 49491-49525 depending on the age of the patient and whether or not the hernia is initial, recurrent, incarcerated/strangulated, or sliding.

What does 7 cm mean incisional hernia?

The 7 cm incision is how they started the surgery. When it says incisional hernia they mean the hernia is from/in a place of a previous surgery where there was an incision made, not meaning how the surgery is performed. If it is an adult and an initial hernia then it sounds like it would be 49505. Mesh is included. K.

What is the code for a sliding inguinal hernia?

There is a separate, specific code — 49525 Repair inguinal hernia, sliding, any age — for the repair of a reducible, sliding inguinal hernia. If the hernia is incarcerated or strangulated, however, 49525 does not apply. Instead, you would revert to 49496, 49501, 49507, or 49521, as appropriate. 8.

What is the code for implanted mesh removal?

Since there is no separate code for implanted mesh removal, use unlisted procedure code 49999 Unlisted procedure, abdomen, peritoneum and omentum to report the service.

What is the code for mesh placement?

If mesh implantation is performed with any other open hernia repair (inguinal, epigastric, umbilical, femoral), do not report +49568 because those codes include mesh placement. Mesh is also included as a part of laparoscopic repair. Do not report +49568 with laparoscopic repair codes 49652–49657.

What is abdominal surgery?

Surgery is directed at permanently closing off the orifice through which the abdominal contents protrude, after returning them to the abdominal cavity. Usually, an incision is made over the hernia and the hernia sac is dissected from any surrounding structures.

Why does my hernia protrude?

This abnormal protrusion occurs due to a weak spot in the surrounding muscle or connective tissue (fascia). In some cases, only an empty sac protrudes through, but if the defect is large enough, the hernia sac can contain abdominal contents, typically part of the intestine.

What is the most common type of hernia?

Inguinal: occurs when abdominal contents, such as fatty or intestinal tissue, bulge through a weak area in the inner groin muscle of the lower abdominal wall at the inguinal canal. This is the most common type of hernia, accounting for 75 percent of all hernias.

Can a hernia be resected?

Depending on the size of the hernia sac, it may be ligated and resected. The muscle tissue is repaired, and the incision is closed. A mesh or other prosthesis may be used for reinforcement of the muscle wall. There are many types of hernias.

Is abdominal wall repair the same as hernia repair?

In general, abdominal wall repair uses the same coding principles and the same code values as hernia repair. An abdominal wall repair is differentiated from a hernia repair by the ICD-10-CM diagnosis codes, not necessarily by the ICD-10-PCS procedure codes. Abdominal wall repair is not coded separately when an associated procedure is performed on an internal organ because procedural steps necessary to close an operative site are considered integral.1

Can a hernia be lysed?

Omental, intestinal, and other abdominal adhesions may be found and lysed during hernia repair, particularly for incarcerated hernias. Lysis is typically not coded separately because it is considered an integral procedural step necessary to reach the operative site. As an exception, lysis of adhesions can be coded separately when the surgeon clearly documents its clinical significance in the operative repair, for example, if the adhesions are extensive and require tedious lysis.

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Article Guidance

Coding Guidelines The Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) code (s) may be subject to National Correct Coding Initiative (NCCI) edits. This information does not take precedence over NCCI edits.

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