General Surgery Coding Alert

Question: Would you please clarify the coding for laparoscopic versus open hernia repair?

Maryland Subscriber

Answer: CPT^® provides different codes for open versus laparoscopic hernia repair for most types of hernia.

Regardless of the type of hernia, the distinction between open and laparoscopic codes is the approach. For open repair, the surgeon accesses the repair site through a skin incision over the site, including cutting through any other involved tissues, and uses retraction as necessary to create an open field to repair the hernia. For laparoscopic repair, the surgeon uses multiple smaller incisions to insert laparoscopic instruments, infuses gas to inflate the area for access to the surgical field, and repairs the hernia through that approach.

CPT^® lists open hernia repair codes in the range 49491-49590, such as 49505 (Repair initial inguinal hernia, age 5 years or older; reducible). For laparoscopic hernia repair, turn to the range 49650-49657, such as 49650 (Laparoscopy, surgical; repair initial inguinal hernia).