General Surgery Coding Alert

Answer: Based on the information you provide, the best code for your surgeon’s work appears to be 49656 (Laparoscopy, surgical, repair, recurrent incisional hernia [includes mesh insertion, when performed]; reducible).

 

A trocar site hernia (TSH) is defined as an incisional hernia that occurs after minimally invasive surgery on the trocar incision site. So you’re dealing with an incisional hernia repair, which leads you to codes 49654-49697 (Laparoscopy, surgical, repair, … incisional hernia …). 

 

You also provide documentation of a prior TSH repair at the site, which means that this is a recurrent incisional hernia. That leads you to 49656 or 49657. Because the surgeon documents a reducible hernia with mesh placement, you should select 49656 instead of 49657, which is for a strangulated or incarcerated hernia repair.