General Surgery Coding Alert

Reader Question:

'Trocar Site' Leads to Incisional Hernia Codes

Question: How should we bill when our surgeon performs a laparoscopic “trocar site” hernia repair?


Florida Subscriber

Answer: You should use the appropriate incisional hernia repair code (49654-49655, Laparoscopy, surgical, repair, incisional hernia [includes mesh insertion, when performed] ...; or 49656-49657, Laparoscopy, surgical, repair, recurrent incisional hernia [includes mesh insertion, when performed] ...) to report the procedure that your physician performed.

Here’s why: A trocar site hernia (TSH) is defined as an incisional hernia. This type of hernia occurs on the trocar incision site after minimally invasive surgery.

The incisional hernia repair codes include payment for services associated with an incisional defect with expected adhesions, scarring, and other extra work associated with a procedure related to a previous surgical site.

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