Outpatient Facility Coding Alert

Question: What’s the code for a hydrocelectomy when it’s performed with an incarcerated hernia repair on an adult patient?

Colorado Subscriber

Answer: For the hydrocelectomy portion of the surgery, you’ll look no further than code 55040 (Excision of hydrocele; unilateral) or 55041 (…bilateral), depending on whether the surgeon excises a hydrocele unilaterally or bilaterally. Next, you’ll look to the appropriate hernia repair code. If the operative report indicates an initial repair of an incarcerated hernia, then you’ll report code 49507 (Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated).

For the repair of a recurrent incarcerated hernia, you’ll report code 49521 (Repair recurrent inguinal hernia, any age; incarcerated or strangulated). If you’re wondering whether the hernia is initial or recurrent, you should see if the surgeon identifies whether a previous surgical intervention has been performed on the hernia. Typically, the surgeon will explicitly state where the hernia repair is initial or recurrent. 

Related Articles

Reader Question: Note Circumstances of Postop Pain Before Determining Dx Code

Reader Question: Know How to Sequence Complication, Condition Codes Properly

Modifiers: Get Familiar With Modifier JW Use in OPPS Settings