General Surgery Coding Alert

Question: If the surgical note doesn't indicate whether an incarcerated femoral hernia is initial or recurrent, how do we choose between 49553 or 49557 for a laparoscopic pre-peritoneal repair?

Ohio Subscriber

Answer: Neither code that you suggest is appropriate for the procedure you describe. That's because your surgeon performed a laparoscopic procedure, while both codes that you suggest describe an open procedure, as follows:

• 49553 -- Repair initial femoral hernia, any age; incarcerated or strangulated
• 49557 -- Repair recurrent femoral hernia; incarcerated or strangulated.

Instead, you should list the procedure using unlisted code 49659 (Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy). CPT® doesn't provide a specific code for laparoscopic femoral hernia repair.