Reduce Coding Confusion Surrounding Inguinal Hernia Repair
Question: A 58-year-old patient presented for surgery on a right inguinal hernia. The patient had a six-month history of an intermittent right inguinal bulge with discomfort at the end of the day. The bulge reduced when the patient was lying down. An ultrasound confirmed the presence of a 1.8 cm indirect inguinal hernia defect. The surgeon performed laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair with hernia sac reduction and synthetic mesh placement to cover the myopectineal orifice, followed by peritoneal closure. How do we report this procedure? New Hampshire Subscriber Answer: Assign 49650 (Laparoscopy, surgical; repair initial inguinal hernia) to report the laparoscopic TAPP inguinal hernia repair with hernia sac reduction. This code applies to an initial hernia repair. If the hernia occurred again in the future and the patient needed another repair, you’d use 49651 (… repair recurrent inguinal hernia). Next, you’ll double-check the operative note to ensure the findings don’t list an obstruction or gangrene associated with the hernia. If the hernia occurred without an obstruction or gangrene, you’ll use K40.90 (Unilateral inguinal hernia, without obstruction or gangrene, not specified as recurrent) to report the patient’s condition. This code identifies that the patient experienced an inguinal hernia on one side of the body (unilateral). Mike Shaughnessy, BA, CPC, Production Editor, AAPC
