Anesthesia Coding Alert

Question: What is the correct anesthesia code for two laparoscopic repairs of incisional hernias? The patient has two ventral hernias, one in the mid-abdomen and the other in the lower abdomen.

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Answer: If the patient has both an upper and lower abdominal hernia surgery, you want to choose the highest-based procedure (00790, Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified, 7 base units) and bill the total time for both procedures.

Double-check for open procedure: You should code open procedures of this kind as 00832 (Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias).

Take a look: It's handy to note that CPT 2009 added new surgical codes for these procedures.

• 49652 -- Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible

• 49653 -- . . . incarcerated or strangulated

• 49654 -- Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); reducible

• 49655 -- . . . incarcerated or strangulated

• 49656 -- Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); reducible

• 49657 - . . . incarcerated or strangulated.