General Surgery Coding Alert

Question: If the surgeon performs a hernia repair on a two-month-old infant that requires continuous infusion of anesthetic via catheter, can we report the infusion separately?

Texas Subscriber

Answer: No, you should not separately report the infusion. There are two hernia repair codes for two-month olds, and Correct Coding Initiative (CCI) bundles catheter infusion of anesthetic (64416, Injection, anesthetic agent; brachial plexus, continuous infusion by catheter [including catheter placement]) into both of them.

When the surgeon performs hernia repair on a two-month-old with this type of anesthetic, you have two choices:

1. Report 49491 (Repair, initial inguinal hernia, preterm infant [less than 37 weeks gestation at birth], performed from birth up to 50 weeks post conception age, with or without hydrocelectomy; reducible) if there is no incarceration or strangulation.

2. Report 49492 (... incarcerated or strangulated) if there is incarceration or strangulation).

-- Reader Questions and You Be the Coder were prepared with the assistance of Marcella Bucknam, CPC, CCS-P, CPC-H, CCS, CPC-P, COBGC, CCC, manager of compliance education for the University of  Washington Physicians Compliance Program.