# Incarcerated Hernia - 49587?



## nlbarnes (Mar 25, 2016)

The content of the umbilical hernia 
was noted to be a preperitoneal fat.  Dissection was carried 
circumferentially to expose the fascia anteriorly, all the way around. 
Once this was performed, the hernia contents were reduced back into 
the preperitoneal space and a small Ventralex patch was brought onto


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## ltrue (Mar 25, 2016)

*Depends on....*

Was the repair open (49587) or laparoscopic (49653)? 

"Incarcerated hernia. If the omentum or a loop of intestine becomes trapped in the weak point in the abdominal wall, it can obstruct the bowel, leading to severe pain, nausea, vomiting, and the inability to have a bowel movement or pass gas."  via mayoclinic.com

I asked a similar question of one of our surgeons and was told that if the hernia is not reducible, it is considered incarcerated.

If you're incarcerated, you're stuck.
If you're strangled, you're dead.

Two ways to remember the difference and to figure out the correct code.

Hope that helps!


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## nlbarnes (Mar 25, 2016)

*Incarcerated hernia*

Hi - thanks for responding.  I view it as incarcerated.  The new group that I'm with does not acknowledge incarcerated at all and I thought, "have I been doing it wrong for the last 7 years?".


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## ltrue (Mar 25, 2016)

*Yikes!*

I just got a second opinion from our head coder and she agrees.  

It's scary they haven't been acknowledging incarcerated hernias. That's a lot of money being left on the table!


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