Urology Coding Alert

Question: How should I code for a laparoscopic parastomal hernia repair? Which CPT Code would be more appropriate to use: unlisted codes 44238 or 49659 if I benchmark to open code 44238 with documentation?

Answer: You should consider a parastomal hernia an incisional hernia. Therefore, 49654 (Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); reducible) is the best choice for your clinical scenario if the documentation indicates that the hernia is reducible. If the physician states the hernia is strangulated or incarcerated, you should then report 49655 (... incarcerated or strangulated).