General Surgery Coding Alert

Question: Using a laparoscope, the surgeon repaired an incarcerated ventral hernia with implantation of mesh. We are unable to find a suitable code for this procedure.


Georgia Subscriber


Answer: You should select 49659 (Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy) for the hernia repair.

Choose the unlisted-procedure code because only inguinal hernias include codes to describe laparoscopic repair (49650, Laparoscopy, surgical; repair initial inguinal hernia). Likewise, you should stay away from 49560 (Repair initial incisional or ventral hernia; reducible) because the code descriptor does not specify "laparoscopic."

As in all cases when you report an unlisted-procedure code, you should provide full documentation with your claim describing the exact nature and extent of the procedure. In this case, you should also document mesh placement during the procedure as an additional step in the surgery. For instance, you could describe the procedure as "lap ventral hernia repair with mesh" and charge accordingly.

You may be tempted to report +49568 (Implantation of mesh or other prosthesis for incisional or ventral hernia repair [list separately in addition to code for the incisional or ventral hernia repair]) in addition to 49659, but you should resist the temptation. Code 49568 is an add-on code for use with incisional and ventral hernia repair codes only. You should not report 49568 with an unlisted-procedure code.