General Surgery Coding Alert

Question: Our surgeon performed a laparoscopic cholecystectomy on a 32-year-old male patient. During closure, the surgeon documented repairing an existing incisional hernia. How should we code the case?

Georgia Subscriber

Answer: The correct coding for this procedure is 47562 (Laparoscopy, surgical; cholecystectomy). You should not separately report the incisional hernia repair using a code such as 49654 (Laparoscopy, surgical, repair, incisional hernia [includes mesh insertion, when performed]; reducible).

Here's why: CPT^® guidelines state that you must bundle the repair of an incisional hernia during closure of a different abdominal surgery.

On the other hand, if the hernia repair is unrelated to the cholecystectomy - that is, the surgeon made a separate incision to repair the hernia - you may list 49654 in addition to 47562. You would need to append a modifier such as 59 (Distinct procedural service) to code 49654 if you report these two codes together.