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General Surgery Coding Alert

Reader Question:

Rely on Unlisted-Procedure Code for Laparoscopy Ventral Hernia Repair

Published on Wed Oct 08, 2003

Question: How can I report laparoscopic ventral hernia repair? Code 49560 seems closest, but it does not specify "laparoscopic."

New York Subscriber Answer: In this case, your only choice is 49659 (Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy). Only inguinal hernias include codes to describe laparoscopic repair (49650, Laparoscopy, surgical; repair initial inguinal hernia). And because 49560 (Repair initial incision or ventral hernia; reducible) does not specify "laparoscopic," you would not report this code either.
 
When you report an "unlisted-procedure" code, you should provide full documentation with the claim. And, if the surgeon places mesh during the procedure, you may report +49568 (Implantation of mesh or other prosthesis for incisional or ventral hernia repair [list separately in addition to the code for incisional or ventral hernia repair]) in addition to 49659. - Technical and coding advice for You Be the Coder and Reader Questions provided by Marcella Bucknam, CPC, CCS-P, CPC-H, CCA, HIM program coordinator at Clarkson College in Omaha, Neb.
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