# 2 Hernias Same Side



## N70QW (Nov 7, 2008)

I don't code surgery very often so I am hopeing someone can help with this one. The pt has an intial right inguinal hernia 49505 and an incarcerated left
inguinal hernia, 49507-51. THis claim is for Medicare and I keep getting it denied for M80 reason code which states basically unbundling. Any suggestions? I am not sure how to bill it bilaterally where they are two different types of hernias. Thanks


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## lavanyamohan (Nov 8, 2008)

N70QW said:


> I don't code surgery very often so I am hopeing someone can help with this one. The pt has an intial right inguinal hernia 49505 and an incarcerated left
> inguinal hernia, 49507-51. THis claim is for Medicare and I keep getting it denied for M80 reason code which states basically unbundling. Any suggestions? I am not sure how to bill it bilaterally where they are two different types of hernias. Thanks



Hi,
Please try and append LT to 49507 and RT to 49505; No need 51 modifier.
I guess both 49505 and 49507 should be coded-as two surgical incisions-two separate codes can be rendered.


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## mbort (Nov 8, 2008)

you may also need a 59 on the 2nd if the rt/lt solution does not work


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## lavanyamohan (Nov 8, 2008)

hello,
Even the dx should be different for both CPTs.
550.90 for the right inguinal hernia
550.10 for the left hernia, that is incarcerated.
With separate Dxs, a 59 modifier is not mandatory.


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## FTessaBartels (Nov 10, 2008)

*-59 modifier*

I would probably use the -59 modifier ... but Lavanya has a good point re differing diagnoses. Be sure to link them appropriately.

F Tessa Bartels, CPC, CPC-E/M


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## SM6489 (Mar 16, 2009)

*Hernia repair*

 When billing 49505 bilaterally how do you enter the charge?  49505, 50 modifier, 2 units? Is this correct?


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## codinggrl (Mar 17, 2009)

I would not bill with the 50 modifier. This will deny. I would code it as 49507 w/dx 550.10 and 49505-59 w/dx 550.90 ( I assume 49507 is more expensive). I would attach a modifier note with an explanation of the billing and the op report. I did coding for an ASC and this is what I did in the past and it should pay. I would make sure the documentation supports the billing!


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## TammyFarris (Mar 17, 2009)

Have you considered billing the 49505 twice and applying the 76 modifier to the second one?


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