Advanced Search

Urology Coding Alert

Reader Question:

Unilateral Hernia Repair

Published on Fri Feb 01, 2002

Question: Our physician performed an exploration for a bilateral hernia but performed the repair on only one side. How should I bill?

Louisiana Subscriber
Answer: If the urologist performs a hernia repair on one side, and explores the other side but doesn't find a hernia, use 49505 (Repair initial inguinal hernia, age 5 years or over; reducible) with modifiers -50 (Bilateral procedure) and -52 (Reduced services) appended. Reimbursement will probably be 110-120 percent, not the full 150 percent of 49505.
 
If the hernia is strangulated or incarcerated, bill 49507 ( incarcerated or strangulated) with appropriate modifiers depending on exploration of the contralateral side.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Urology Coding Alert

View All