Urology Coding Alert
Herniorrhaphy with Excision of Hydrocele
New Jersey Subscriber
Answer: Add modifier -22 (Unusual procedural services) to the herniorrhaphy, billing 49505 (Repair initial inguinal hernia, age 5 years or over; reducible). Hernia repair codes do not distinguish between male and female. Therefore, in this case, report 49505. An inguinal hernia in a female and the hydrocele in the inguinal canal are unusual findings. A hydrocele in a female is a fluid collection hydrocele in the canal of Nuck (629.1). There is no code for the excision of this type of lesion. Use 49505-22 to indicate the extra work for its excision. This represents about 25 percent more work. Do not bill 55500 (Excision of hydrocele of spermatic cord, unilateral [separate procedure]) because this will result in a gender edit and claim denial.
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