Urology Coding Alert
Work Your Way Down the Path to Proper Orchiopexy and Hernia Repair Pay
Keep a copy of the handy chart close by to ensure you choose the right codes every time.
When your urologist performs an inguinal orchiopexy and a hernia repair in the same surgical session, you can report both procedures. Work your way through the following questions to determine which codes you should report based on your physician’s work.
Flow Sheet for Up-to-Date Treatment of the Undescended Testicle
Note: The order in which you sequence the orchiopexy and hernia repair codes will vary depending on which hernia repair code you use. Remember to place modifier 51 (Multiple procedures) on the orchiopexy code when you report 49496 or 49501-49525 as these hernia repair codes have higher relative value units (RVUs) than 54640, and you should bill the hernia repair as the primary procedure. On the other hand, add modifier 51 to the hernia code if you’re reporting 49495 or 49500 with the orchiopexy. The orchiopexy code has the higher RVUs than the two hernia repair codes, and you should bill 54640 as the primary procedure.
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