# Help with CPT code for Repair of incisional hernia + partial omentectomy



## dawnlamb

Does 49560 include partial omentectomy?

Scrubbed note below:

The incisional hernia could be palpated over the lateral aspect of the previous open cholecystectomy incision.  The lateral third of the previous surgical incision was then opened and extended approximately 5 cm laterally.  Dissection was carried down through a large amount of subcutaneous tissues.  The anterior fascia was identified.  Fatty tissue was dissected off of the anterior fascia, and this was found to be consistent with the hernia sac containing a portion of the omentum in the sac extending through the fascia.

The hernia sac was then opened.  A portion of the incarcerated omentum was then removed and resected.  After this portion of the omentum was removed, it was submitted for permanent pathology.  

After the dissection was completed, the incisional hernia was repaired with a proceed ventral patch mesh.

Please help me; I am stumped with which CPT code(s) to use!!!!  Thank you


----------



## preserene

*49561 +49568*

*49561* becuase it is an incarcerated hernia ( 'incanceration' in hernia refers in terms of the internal tissues or organs getting jammed up in to the defective facia or ring an dbecomes irreducible).
*49568 *as per the CPT guidelines,  the incisional/ventral hernias when performed with the mesh for closure should be listed separately in addition to the code fpr the primary procedure. Partial omentectomy is a component of the incarcerated hernia repair
Hope this helps. but when it comes to organ system excision, appropriate excision code might be used in addtion to the appr code for repair of the strangulated hernia.


----------



## Grintwig

I agree with preserene the omentectomy in this case is part of the procedure and therefore uncodeable. And I also agree with the code choices. 
If the doctor feels the extra work he did was extreme you could append a 22 to 49561 and send the OP note to support it.


----------

