General Surgery Coding Alert

Question: I've heard conflicting advice on whether I should append modifier -50 to hernia repairs. May I use modifier -50 for repair of bilateral inguinal hernia?

Montana Subscriber

Answer: Modifier -50 (Bilateral procedure) is appropriate for most types of hernia repair except umbilical (49580-49587 and 49600-49611) and hiatal (39502-39541). Therefore, you may report modifier -50 for repair of bilateral inguinal hernia (49491-49525). The operative note should make clear that the repair occurred on both sides. Generally, the payer will increase reimbursement with modifier -50 to 150 percent of the usual fee (for example, if a unilateral surgery pays $200, the bilateral equivalent will pay $300).