Outpatient Facility Coding Alert

Question: What CPT® codes should I use to report a laparoscopic bilateral inguinal hernia repair and a right-sided femoral hernia repair also done laparoscopically?

Arkansas Subscriber

Answer: The answer depends on whether your physician is repairing an initial or recurrent inguinal hernia. Since the femoral hernia is being laparoscopically repaired, you do not need to consider whether the femoral hernia is reducible, strangulated, or incarcerated — or initial or recurrent.

Assuming that you are reporting codes for an initial bilateral laparoscopic inguinal hernia repair, you will report the following codes:

• 49650-LT (Left Side) — Laparoscopy, surgical; repair initial inguinal hernia
• 49650-RT (Right Side)
• 49659 — Unlisted laparoscopy procedure, hernio­plasty, herniorrhaphy, herniotomy.

Remember: You should not append any modifiers to the unlisted code. Additionally, you should submit this claim both on paper and electronically (for timely filing). When submitting on paper, make sure to include a copy of the operative report, a comparison code, and rationale for why you believe femoral hernia repair deserves the same reimbursement as that of the comparison code.

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