General Surgery Coding Alert

Question: During an inguinal hernia repair (49505) with mesh, the surgeon performs an excision of a lipoma of the spermatic cord. Should I report an additional code for the excision? The pathology report shows the specimen is a "hernia sac," and final diagnosis is "fibroadipose tissue." Pennsylvania Subscriber Answer: Code 55520 (Excision of lesion of spermatic cord [separate procedure]) properly describes excisions of the type your surgeon performed. But 55520 is a designated "separate procedure" that occurs here with a related primary procedure, the hernia repair 49505 (Repair initial inguinal hernia, age 5 years or older; reducible). Therefore, correct coding dictates that you bundle the excision into the hernia repair. In short: You would report only the hernia repair, as usual, using 49505, with no additional code for the excision of the spermatic cord lipoma.